Methods and Compositions for Producing Active Vitamin K-Dependent Proteins

ABSTRACT

The present invention provides methods and compositions for the production of vitamin K dependent proteins.

STATEMENT OF PRIORITY

This application is a 35 U.S.C. §371 national phase entry of PCT Application PCT/US2011/066379, filed Dec. 21, 2011, which claims the benefit, under 35 U.S.C. §119(e), of U.S. Provisional Application Ser. No. 61/425,652, filed Dec. 21, 2010, U.S. Provisional Application Ser. No. 61/506,436, filed Jul. 11, 2011, and U.S. Provisional Application Ser. No. 61/,540,374, filed Sep. 28, 2011, the entire contents of each of which are incorporated by reference herein.

GOVERNMENT SUPPORT

Aspects of this invention were produced using federal funds under Grant Nos. HL077740, HL048318 and HL06350, awarded by the National Institutes of Health. Accordingly, the U.S. Government has certain rights in this invention.

FIELD OF THE INVENTION

The present invention is directed to isolated nucleic acids, host cells containing the same, and methods of use thereof, in the production of vitamin K dependent proteins.

BACKGROUND OF THE INVENTION

The function of numerous proteins requires the modification of multiple glutamic acid residues to γ-carboxyglutamate. Among these vitamin K-dependent (VKD) coagulation proteins, factor IX (FIX; Christmas factor), factor VII (FVII), and prothrombin are the best known. The observation that a knock-out of the gene for matrix Gla protein results in calcification of the mouse's arteries (Luo et al. (1997) “Spontaneous calcification of arteries and cartilage in mice lacking matrix GLA protein” Nature 386:78-81) emphasizes the importance of the vitamin K cycle for proteins with functions other than coagulation. Moreover, Gas6 and other Gla proteins of unknown function are expressed in neural tissue and warfarin exposure in utero results in mental retardation and facial abnormalities. This is consistent with the observation that the expression of VKD carboxylase, the enzyme that accomplishes the Gla modification, is temporally regulated in a tissue-specific manner with high expression in the nervous system during early embryonic stages. Concomitant with carboxylation, reduced vitamin K, a co-substrate of the reaction, is converted to vitamin K epoxide. Because the amount of vitamin K in the human diet is limited, vitamin K epoxide must be converted back to vitamin K by vitamin K epoxide reductase (VKOR) to prevent its depletion.

VKOR is a polytopic membrane protein of the endoplasmic reticulum (ER). It is responsible for the conversion of vitamin K epoxide (KO) to vitamin K and is highly sensitive to inhibition by coumarin drugs, such as warfarin. Warfarin inhibition of VKOR reduces the availability of reduced vitamin K (vitamin K hydroquinone, KH₂), which is a cofactor for γ-glutamyl carboxylase that catalyzes the functionally critical post-translational modification of a family of vitamin K-dependent proteins involved in blood coagulation, bone homeostasis, signal transduction, and cell proliferation. Bioinformatic analyses showed that VKOR is a member of a large family of homologues (VKORH) widely distributed throughout evolution. Characterizations of the human VKOR and VKORH from bacteria have yielded a large amount of structure-function information, but some is contradictory. A four-transmembrane domain (TMD) model for human VKOR was proposed based on the crystal structure of VKORH from Synechococcus sp. This model is different from a previous three-TMD topology model in terms of the location of the N-terminus and the conserved cysteine (C43 and C51) loop between the first and second TMD.

The present invention provides methods and compositions for producing vitamin K dependent proteins.

SUMMARY OF THE INVENTION

The present invention provides (1) a method of increasing the amount of carboxylated vitamin K dependent protein in a cell, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein, a second nucleic acid comprising a heterologous nucleotide sequence encoding vitamin K epoxide reductase (VKOR), under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, thereby increasing the amount of carboxylated vitamin K dependent protein in the cell.

Additionally provided herein is (2) a method of increasing the carboxylation of a vitamin K dependent protein, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein, a second nucleic acid comprising a heterologous nucleotide sequence encoding vitamin K epoxide reductase (VKOR), under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, thereby increasing the carboxylation of the vitamin K dependent protein in the cell.

The present invention also provides (3) a method of producing a carboxylated vitamin K dependent protein in a cell, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein, a second nucleic acid comprising a heterologous nucleotide sequence encoding vitamin K epoxide reductase (VKOR), under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, wherein the amount of carboxylated vitamin K dependent protein produced in the cell in the presence of VKOR produced by the second nucleic acid is increased as compared to the amount of carboxylated vitamin K dependent protein produced in the cell in the absence of VKOR produced by the second nucleic acid, thereby producing a carboxylated vitamin K dependent protein in the cell.

In the methods designated (1), (2) and (3) above, the heterologous nucleotide sequence encoding VKOR can be but is not limited to:

1) a nucleotide sequence that encodes an amino acid sequence having at least about 19% identity but not greater than about 79% identity at the amino acid sequence level with a human VKOR amino acid sequence such as the amino acid sequence of GenBank® Accession No. AAS01052 as well as any other human VKOR amino acid sequence now known or later identified, wherein the amino acid sequence has VKOR activity (e.g., at least 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%, 110%, 120%, 130%, 140%, 150%, etc., relative to the activity of a control (e.g., a wild type human VKOR or unmodified human VKOR) as determined according to the methods described in the Examples section herein and as are known in the art;

2) a nucleotide sequence that encodes a Mycobacterium tuberculosis VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. NP_(—)217484);

3) a nucleotide sequence that encodes an Acropora VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. EZ012735);

4) a nucleotide sequence that encodes a Nematostella VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. XP_(—)001627634);

5) a nucleotide sequence that encodes an Amphioxus VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. XP_(—)002611889 (exemplary nucleotide sequence provided as GenBank® Accession No. XM_(—)001611843);

6) a nucleotide sequence that encodes a Takifugu VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. NP_(—)001027838);

7) a nucleotide sequence that encodes a Ciona VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. NP_(—)001073142);

8) a nucleotide sequence that encodes a hamster VKOR (non limiting examples of which include the VKOR having the amino acid sequence of SEQ ID NO:X obtained from Syrian golden hamster cell line MCB3901 [AV12-664]; Accession No. CRL-9595 and the VKOR having the amino acid sequence provided as GenBank® Accession No. XP_(—)003511033.1);

9) a nucleotide sequence that encodes a Drosophila VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. NP_(—)001014533);

10) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052), comprising a C51A mutation;

11) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052), comprising an IV133-134PY mutation;

12) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052), comprising a C51A mutation and an IV133-134PY mutation;

13) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052), comprising a V45N mutation;

14) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052), comprising a substitution of amino acids 44-50 with amino acids DYKDDDDK;

15) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052) with amino acids 129-146 (FQSLYRIGALCPYCMVVW) of Mycobacterium tuberculosis VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. NP_(—)217484);

16) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052) with amino acids 185-202 (ILSTKLSGSSCLYCLVSA) of Arabidopsis VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as QenBank® Accession No. NP_(—)567988);

17) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052) with amino acids 120-137 (YLMVAVLRQFCMYCTTAI) of Synechococcus VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. YP_(—)478481);

18) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052) with amino acids 33-50 (WFQHVMLLKPCVLCIYER) of a bacterial DsbB enzyme (a nonlimiting example of which is the DsbB enzyme having the amino acid sequence provided as GenBank® Accession No. ZP_(—)03067529); and/or

19) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052) with amino acids 300-317 (FLEPFVIGATCLWCLTSA) of Roseiflexus VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. YP_(—)001274867).

A further aspect of the present invention is a cell (e.g., a host cell) comprising, consisting essentially of, or consisting of a nucleic acid comprising a heterologous nucleotide sequence encoding a vitamin K epoxide reductase (VKOR) protein (e.g., a recombinant protein) that has at least about 19% identity but not greater than about 79% identity (including 19% 20%, 21%, 22%, 23%, 24%, 25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60%, 61%, 62%, 63%, 64%, 65%, 66%, 67% 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%, 78% and 79%) at the amino acid sequence level with a human VKOR amino acid sequence such as the amino acid sequence of GenBank® Accession No. AAS01052 as well as any other human VKOR amino acid sequence (e.g., any other human VKOR variant) now known or later identified, wherein the recombinant protein has VKOR activity (e.g., at least 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%, 110%, 120%, 130%, 140%, 150%, etc., relative to the activity of control (e.g., wild type human VKOR or unmodified human VKOR) as determined according to the methods described in the Examples section herein and as are known in the art.

The present invention additionally provides a cell (e.g., a host cell) comprising, consisting essentially of, or consisting of a nucleic acid comprising a heterologous nucleotide sequence encoding vitamin K epoxide reductase (VKOR) that can be, but is not limited to:

1) a nucleotide sequence that encodes an amino acid sequence having at least about 19% identity but not greater than about 79% identity at the amino acid sequence level with a human VKOR wild type amino acid sequence such as the amino acid sequence of GenBank®Accession No. 2 as well as any other human VKOR wild type amino acid sequence (e.g., any other human VKOR variant) now known or later identified, wherein the recombinant protein has VKOR activity (e.g., at least 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%, 110%, 120%, 130%, 140%, 150%, etc., relative to the activity of control (e.g., wild type human VKOR or unmodified human VKOR) as determined according to the methods described in the Examples section herein and as are known in the art;

2) a nucleotide sequence that encodes a Mycobacterium tuberculosis VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. NP_(—)217484);

3) a nucleotide sequence that encodes an Acropora VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. EZ012735);

4) a nucleotide sequence that encodes a Nematostella VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. XP_(—)001627634);

5) a nucleotide sequence that encodes an Amphioxus VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. XP_(—)002611889 (exemplary nucleotide sequence provided as GenBank® Accession No. XM_(—)001611843).);

6) a nucleotide sequence that encodes a Takifugu VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. NP_(—)001027838);

7) a nucleotide sequence that encodes a Ciona VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. NP_(—)001073142);

8) a nucleotide sequence that encodes a hamster VKOR (non limiting examples of which include the VKOR having the amino acid sequence of SEQ ID NO:X obtained from Syrian golden hamster cell line MCB3901 [AV12-664]; Accession No. CRL-9595 and the VKOR having the amino acid sequence provided as GenBank® Accession No. XP_(—)003511033.1);

9) a nucleotide sequence that encodes a Drosophila VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. NP_(—)001014533);

10) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052), comprising a C51A mutation;

11), a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052), comprising an IV133-134PY mutation;

12), a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052) comprising a C51A mutation and an IV133-134PY mutation;

13) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052), comprising a V45N mutation;

14) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052), comprising a substitution of amino acids 44-50 with amino acids DYKDDDDK;

15) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052) with amino acids 129-146 (FQSLYRIGALCPYCMVVW) of Mycobacterium tuberculosis VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. NP_(—)217484);

16) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVITTY) of human VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052) with amino acids 185-202 (ILSTKLSGSSCLYCLVSA) of Arabidopsis VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. NP_(—)567988);

17) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052) with amino acids 120-137 (YLMVAVLRQFCMYCTTAI) of Synechococcus VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. YP_(—)478481);

18) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052) with amino acids 33-50 (WFQHVMLLKPCVLCIYER) of a bacterial DsbB enzyme (a nonlimiting example of which is a DsbB enzyme having the amino acid sequence provided as GenBank® Accession No. ZP_(—)03067529); and/or

19) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052) with amino acids 300-317 (FLEPFVIGATCLWCLTSA) of Roseiflexus VKOR (a nonlimiting example of which is a VKOR having the amino acid sequence provided as GenBank® Accession No. YP_(—)001274867).

An additional aspect of the present invention is a recombinant nucleic acid comprising a nucleotide sequence encoding vitamin K epoxide reductase (VKOR) as described herein operatively associated with a heterologous promoter. Such a recombinant nucleic acid can be present in a cell (e.g., a transformed cell).

A further aspect of the present invention is a cell that contains and expresses a recombinant nucleic acid as described herein. Such a cell can be a transformed cell. Suitable cells of this invention include but are not limited to, plant, animal, mammal, insect, yeast and bacterial cells.

Any of the recombinant proteins of this invention as described herein (e.g., those enumerated above as 1-17) can have an amount of VKOR activity (e.g., at least 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%, 110%, 120%, 130%, 140%, 150%, etc.), relative to the activity of a control VKOR (e.g., a wild type human VKOR or unmodified VKOR) as determined according to the methods described in the Examples section herein and as are known in the art.

A further aspect of the present invention is a method of making a vitamin K dependent protein, comprising culturing a cell that expresses a nucleotide sequence encoding a vitamin K dependent protein in the presence of vitamin K and produces a vitamin K dependent protein, and then harvesting the vitamin K dependent protein from the culture, the cell containing and expressing a heterologous nucleotide sequence encoding vitamin K epoxide reductase (VKOR) as described herein and producing recombinant VKOR as described herein.

In some embodiments, the cell can further contain and express a heterologous nucleotide sequence encoding vitamin K dependent carboxylase and thereby produce the vitamin K dependent carboxylase as described herein. Thus, the present invention further provides a cell (e.g., a host cell) comprising, consisting essentially of, or consisting of a first heterologous nucleic acid encoding vitamin K dependent carboxylase and a second heterologous nucleic acid encoding vitamin K epoxide reductase. The cell can further comprise a nucleotide sequence encoding a vitamin K dependent protein, which nucleotide sequence encoding the vitamin K dependent protein can be heterologous to the cell (e.g., when the cell is a plant cell or insect cell) or endogenous to the cell (e.g., when the cell is a mammalian cell).

In further embodiments, the present invention provides a method of identifying a substance that regulates activity of Mycobacterium tuberculosis vitamin K epoxide reductase (VKOR), comprising determining the activity of Mycobacterium tuberculosis VKOR in the presence and absence of the substance by: a) contacting a recombinant Mycobacterium tuberculosis VKOR with a reporter protein under conditions whereby carboxylation of the reporter protein by the Mycobacterium tuberculosis VKOR can occur; and b) measuring the amount of carboxylation of the reporter protein by Mycobacterium tuberculosis VKOR in the presence and absence of the substance, whereby an increase or decrease in the amount of carboxylation of the reporter protein by Mycobacterium tuberculosis VKOR as compared to a control identifies the substance as a substance that regulates activity of Mycobacterium tuberculosis VKOR

Also provided herein is a method of identifying a substance for treating and/or preventing infection and/or disease caused by Mycobacterium tuberculosis, comprising determining the activity of Mycobacterium tuberculosis VKOR in the presence and absence of the substance by: a) contacting a recombinant Mycobacterium tuberculosis VKOR with a reporter protein under conditions whereby carboxylation of the reporter protein by the Mycobacterium tuberculosis VKOR can occur; and b) measuring the amount of carboxylation of the reporter protein by Mycobacterium tuberculosis VKOR in the presence and absence of the substance whereby a decrease in the amount of carboxylation of the reporter protein by Mycobacterium tuberculosis VKOR in the presence of the substance as compared to a control identifies the substance as a substance for treating and/or preventing infection and/or disease caused by Mycobacterium tuberculosis.

In one aspect, the present invention provides a method of increasing the amount of carboxylated vitamin K dependent protein in a cell, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein, a second nucleic acid comprising a heterologous nucleotide sequence encoding a human vitamin K epoxide reductase (VKOR), (a nonlimiting example of which is the human VKOR having the amino acid sequence of GenBank® Accession No. AAS01052), comprising an R37G mutation, an R35G mutation, an R33G mutation, a K30L mutation, a G9R mutation, a S7R mutation and a G6R mutation, under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, thereby increasing the amount of carboxylated vitamin K dependent protein in the cell.

A further aspect of the present invention is a method of increasing the carboxylation of a vitamin K dependent protein, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein, a second nucleic acid comprising a heterologous nucleotide sequence encoding a human vitamin K epoxide reductase (VKOR), (a nonlimiting example of which is the human VKOR having the amino acid sequence of GenBank® Accession No. AAS01052), comprising an R37G mutation, an R35G mutation, an R33G mutation, a K30L mutation, a G9R mutation, a S7R mutation and a G6R mutation, under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, thereby increasing the carboxylation of the vitamin K dependent protein in the cell.

An additional aspect of this invention is a method of producing a carboxylated vitamin K dependent protein in a cell, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein, a second nucleic acid comprising a heterologous nucleotide sequence encoding a human vitamin K epoxide reductase (VKOR), (a nonlimiting example of which is the human VKOR having the amino acid sequence of GenBank® Accession No. AAS01052), comprising an R37G mutation, an R35G mutation, an R33G mutation, a K30L mutation, a G9R mutation, a S7R mutation and a G6R mutation, under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, wherein the amount of carboxylated vitamin K dependent protein produced in the cell in the presence of VKOR produced by the second nucleic acid is increased as compared to the amount of carboxylated vitamin K dependent protein produced in the cell in the absence of VKOR produced by the second nucleic acid, thereby producing a carboxylated vitamin K dependent protein in the cell.

In some embodiments of the methods of this invention, the cell can further comprise a third nucleic acid comprising a heterologous nucleotide sequence encoding a vitamin K dependent gamma carboxylase (VKGC), as are well known in the art.

In some embodiments of this invention, the vitamin K dependent protein can be Factor VII, Factor IX, Factor X, Protein C, Protein S, prothrombin and any combination thereof.

In various embodiments of the methods of this invention, the cell can be a plant cell or an insect cell and the first nucleic acid encoding the vitamin K dependent protein can be a heterologous nucleic acid. In some embodiments of the methods of this invention, the cell can be a mammalian cell and the first nucleic acid encoding the vitamin K dependent protein can be an endogenously produced vitamin K dependent protein or the first nucleic acid encoding the vitamin K dependent protein can be a heterologous vitamin K dependent protein.

The present invention further provides an isolated nucleic acid molecule comprising a nucleotide sequence encoding a human vitamin K epoxide reductase (VKOR), (a nonlimiting example of which is the human VKOR having the amino acid sequence of GenBank® Accession No. AAS01052) comprising an R37G mutation, an R35G mutation, an R33G mutation, a K30L mutation, a G9R mutation, a S7R mutation and a G6R mutation.

Further provided herein is a VKOR protein comprising an amino acid sequence produced by translation of a nucleotide sequence encoding a human vitamin K epoxide reductase (VKOR), (a nonlimiting example of which is the human VKOR having the amino acid sequence of GenBank® Accession No. AAS01052) comprising an R37G mutation, an R35G mutation, an R33G mutation, a K30L mutation, a G9R mutation, a S7R mutation and a G6R mutation.

Also provided is a cell (e.g., an isolated cell or a transformed cell) comprising the nucleic acid molecule of this invention and/or the VKOR protein comprising an amino acid sequence of this invention. Additionally provided is a vector comprising the nucleic acid molecule of this invention and in some embodiments, a cell comprising the vector of this invention. In various embodiments, the cell can be a plant cell, an insect cell or a mammalian cell.

These and other aspects of the invention are set forth in more detail in the description of the invention below.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1. Vitamin K Cycle. During vitamin K-dependent carboxylation of glutamic acid to γ-carboxyglutamic acid, the reduced form of vitamin K (KH₂) is oxidized to vitamin K epoxide (KO) by gamma glutamyl carboxylase (GGCX). KO is reduced to vitamin K by VKOR using the enzyme's two active site cysteine residues. This reaction is sensitive to warfarin inhibition. The reduction of vitamin K to KH₂ is carried out in two pathways. One pathway is sensitive to warfarin inhibition and also involves two free cysteine residues in the enzyme active site (VKOR). The second pathway is resistant to warfarin and uses NAD(P)H as a cofactor.

FIG. 2. Effect of vitamin K, KO, and warfarin on FIXgla-PC carboxylation and secretion. Carboxylated (black bar) and total (gray bar) FIXgla-PC secreted from HEK293 cells under different culture conditions was measured by ELISA. Control: complete medium (no added vitamin K); K: complete medium with 11 μM vitamin K; KO: complete medium with 5 μM KO; KO+W: complete medium with 5 μM KO and 2 μM warfarin

FIGS. 3A-B. Effect of warfarin on FIXgla-PC carboxylation in HEK 293 cells. (A) Cells in culture medium with either 11 μM vitamin K (open circles) or 5 μM KO (filled circles) were incubated for 48 h with increasing concentrations of warfarin. The concentration of carboxylated FIXgla-PC in the medium was measured by ELISA. The data are presented as percentages to make the first concentration points of vitamin K and KO coincide. (B) Cells were grown with (open circles) or without (filled circles) 2 μM warfarin in increasing concentrations of vitamin K for 48 h. The concentration of carboxylated FIXgla-PC in the culture medium was measured by ELISA.

FIGS. 4A-B. Effect of warfarin on FIXgla-PC carboxylation in AV12 cells. (A) Cells grown in culture medium with either 11 μM vitamin K (open circles) or 5 μM KO (filled circles) were incubated for 48 h with increasing concentrations of warfarin. The concentration of carboxylated FIXgla-PC in the medium was detected by ELISA. The data are presented as percentages to make the first concentration points of vitamin K and KO coincide. (B) Cells were grown with (open circles) or without (filled circles) 2 μM warfarin in increasing concentrations of vitamin K for 48 h. The concentration of carboxylated reporter protein in the culture medium was measured by ELISA.

FIGS. 5A-B. Endogenous VKOR and GGCX activity in HEK293 and AV12 cells as measured by in vitro enzymatic activity assay. (A) Endogenous GGCX activity of 1×10⁶ HEK293 or AV12 cells was determined as described herein using FLEEL as substrate in the presence of propeptide. (B) Endogenous VKOR activity of 1×10⁷ HEK293 or AV12 cells was determined as described herein using K1₍₂₅₎ as the HPLC standard.

FIGS. 6A-B. Effect of dicoumarol on the carboxylation of the FIXgla-PC in HEK293 and AV12 cells. Increasing concentrations of dicoumarol were added to the cell culture medium with either 11 μM K (open circles) or 5 μM KO (filled circles) and incubated with HEK293 (A) or AV12 (B) cells for 48 hours. The concentration of carboxylated FIXgla-PC in the medium was measured by ELISA. The data are presented as percentages to make the first concentration points of vitamin K and KO coincide.

FIGS. 7A-B. Effect of the warfarin resistant VKOR mutant on FIXgla-PC carboxylation. (A) Warfarin resistant VKOR-Y139F mutant was transiently expressed in HEK293 (black bars) and AV12 cells (gray bars). Thirty hours after transfection, cells were cultured in medium containing 5 μM KO and 2 μM warfarin for 48 h. The concentration of carboxylated FIXgla-PC in the medium was measured by ELISA. The control was the cell line transfected with empty vector, representing endogenous VKOR. (B) AV12 cells (black bars) or AV12 cells that were stably expressing warfarin resistant VKOR-Y139F mutant (gray bars) were cultured in medium containing 5 μM KO (KO) or 5 μM KO and 2 μM warfarin (KO+W) for 48 h. The concentration of carboxylated FIXgla-PC in the medium was measured by ELISA.

FIG. 8. Sequence alignments of VKOR amino acid sequences of 14 diverse species.

FIG. 9. VKOR activity of several VKOR proteins from diverse species as shown by amount of carboxylated reporter protein according to the cell-based carboxylation assay described herein. 40 h incubation with 5 μM KO, 2 μM warfarin, FIXgla-PC HEK293 cell line.

FIG. 10. Relative activity of VKORs as described herein. Y139F: human VKOR rendered warfarin resistant by Y139F mutation; Nematostella Y135F: VKOR from Nematostella rendered warfarin resistant by Y135F mutation; MTVKOR: Mycobacterium tuberculosis VKOR; C51A/Y139F: human VKOR with C51A and Y139F mutations; Syn.VKHu: VKOR from Synechococcus; Syn,VKTrxHu: VKOR from Synechococcus fused with a thioredoxin type enzyme. FIXgla-PC HEK293 cells, 48 h incubation with 5 μM KO, 2 μM warfarin (x-fect).

FIGS. 11A-C. A. Relative activity of M. tuberculosis compared to human warfarin resistant VKOR (Y139F). 48 h incubation with 5 μM KO, 2 μM warfarin, FIXgla-PC HEK293 cell line. B. Ability of human VKOR to stimulate carboxylation with VK substrate with inserts from various thioredoxin enzymes. 48 h incubation with 11 μM K, 2 μM warfarin, FIXgla-PC AV-12 cell line. Each sample is made with human VKOR with residues 122-139 replaced with those of bacterial DsbB 33-50, Mycobacterium tuberculosis 129-146, Arabidopsis 185-202, Roseiflexus sp. 300-317, Synechococcus 12-137. The readout is carboxlyation of reporter protein. C. Human VKOR with residues 122-139 replaced with analogous residues from other thioredoxin enzymes. Activity with VKOR in HEK293 cells. 48 h incubation with 5 μM KO, 2 μM warfarin, FIXgla-PC HEK293 cell line. Each sample is made with human VKOR with residues 122-139 replaced with those of bacterial DsbB 33-50, Mycobacterium tuberculosis 129-146, Arabidopsis 185-202, Roseiflexus sp. 300-317, Synechococcus 120-137. The readout is carboxlyation of reporter protein.

FIG. 12. Amount of carboxylated reporter protein produced in cell-based carboxylation assay described herein using recombinant human VKOR comprising various mutations as described herein.

FIG. 13. In vivo study of cysteine residues in human VKOR.

FIG. 14. Comparison of conserved motifs within VKORs.

FIGS. 15A-B. Reduction of KO to vitamin K by VKORHs to support VKD carboxylation in HEK293 cells (A) Schematic representation of the vitamin K epoxide reductase homologs (VKORHs) and controls used in this study. The solid bars indicate the transmembrane domain (TMD) predicted by TOPCONS (39) or experimentally determined TMD for human VKOR (23) and DsbB (40). The gray bars indicate the thioredoxin-like (Trx-like) domain. For Arabidopsis VKORH, the N-terminal extension that is predicted to encode plastid targeting peptides (19) was removed for the topology prediction. The alignment of VKORHs is based on the TMD containing CXXC redox center. MT-VKORH: Mycobacterium tuberculosis VKORH; SY-VKORH: Synechococcus sp. VKORH; RO-VKORH: Roseiflexus sp. RS-1 VKORH; AR-VKORH: Arabidopsis VKORH. (B) Cell-based activity assay of VKORHs to reduce KO to vitamin K. VKORHs and controls were transiently expressed in FIXgla-PC/HEK293 cells. Cells were cultured in the complete medium containing 5 μM KO and 4 μM warfarin for 48 hours. The concentration of carboxylated FIXgla-PC (Protein C with its gla domain exchanged with factor IX) in the cell culture medium was measured by ELISA and normalized by luciferase activity as described herein.

FIG. 16. Reduction of KO to vitamin K by MT-VKORH cysteine mutants to support VKD carboxylation in HEK293 cells. MT-VKORH and its cysteine mutants were transiently expressed in FIXgla-PC/HEK293 cells and the enzymatic activity was determined as described in FIG. 15.

FIGS. 17A-B. Cell-based activity assay of VKOR cysteine mutants. (A) Individual cysteines in warfarin resistant VKOR (Y139F) were mutated to alanine. These mutant proteins were transiently expressed in FIXgla-PC/HEK293 cells and the enzymatic activity was determined as described in FIG. 15. The results are shown as black bars with the γ-axis on the left. The gray bars represent previous in vitro results (14). (B) Activity assays of the double mutation C43A and C51A (C43/51A), deletion of these two cysteines and the residues between them (C43-51-DEL), and mutation of five cysteines (C16A, C43A, C51A, C85A, and C96A) simultaneously (5C-Mut).

FIGS. 18A-B. Localization of conserved loop cysteines 57/65 and the C-terminus of MT-VKORH by N-linked glycosylation mapping. (A) Schematic representation of the proposed membrane topology of human VKOR (23) and MT-VKORH (8). Conserved loop cysteines are indicated by black dots, Y indicates the introduced N-linked glycosylation site. The CXXC redox center is located near the N-terminus of the third transmembrane domain (TMD) in human VKOR and the fourth TMD in MT-VKORH; both face the ER lumen. (B) Localization of the introduced glycosylation site in MT-VKORH by western blot assay. HPC4 tagged MT-VKORH (MT-VKORH) and its glycosylation mutants (NST60: glycosylation site was introduced between cysteine 57 and 65; NSTend: glycosylation site was introduced at the C-terminus) were transiently expressed in HEK293 cells. Cell lysate was treated with or without PNGase F before being subjected to SDS-PAGE. HPC4 tagged protein bands were probed with anti-HPC4 monoclonal antibody and visualized by ECL western blot reagents. (C) Cell-based activity assay of MT-VKORH glycosylation mutants. MT-VKORH and its glycosylation mutants were transiently expressed in FIXgla-PC/HEK293 cells and the enzymatic activity was determined as described in FIG. 15.

FIGS. 19A-B. Reduction of vitamin K to KH₂ by VKORHs to support VKD carboxylation in AV12 cells. (A) Cell-based activity assay of VKORHs to reduce vitamin K to KH₂. VKORHs from different species were transiently expressed in FIXgla-PCNKOR-Y139F/AV12 cell line and the enzymatic activity was determined as described in FIG. 15. (B) Warfarin resistant human VKOR and MT-VKORH were transiently expressed in the FIXgla-PC/AV12 cell line and the enzymatic activity was determined as described in FIG. 15.

FIGS. 20A-B. Effect of the dipeptide sequence between the two cysteines of the CXXC redox center on VKOR activity. (A) Active site sequence alignment of human VKOR and its homologues tested in this study. The sequence used for alignment is from the C-terminus of the second TMD to the C-terminus of the third TMD of human VKOR (Cite sequences here). Conserved residues are highlighted. AR-VKORH: Arabidopsis VKORH; MT-VKORH: Mycobacterium tuberculosis VKORH; RO-VKORH: Roseiflexus VKORH; SY-VKORH: Synechococcus VKORH. (B) Cell-based activity assay of MT-VKORH, MT-VKORH-P1401/Y141V, human VKOR and human VKOR-1133P/Y134Y. MT-VKORH, human VKOR and the mutant enzymes were transiently expressed in FIXgla-PC/HEK293 cells and the enzymatic activity was determined as described in FIG. 15.

FIGS. 21A-C. Cell-based activity assay of reduction of KO and vitamin K by bacterial VKORHs with sequences similar to MT-VKORH. (A) Active site sequence alignment of MT-VKORH and the other two bacterial VKORHs with similar sequence. (Cite sequences here) Conserved residues are highlighted. Active site cysteines are indicated by arrows. CO-VKORH: Corynebacterium jeikeium VKORH; SA-VKORH: Salinispora tropica VKORH. (B) Cell-based assay of reduction of KO to vitamin K by the selected bacterial VKORHs in FIXgla-PC/HEK293. VKORHs were transiently expressed in FIXgla-PC/HEK293 cells and the enzymatic activity was determined as described in FIG. 15. (C) Cell-based activity assay of reduction of vitamin K to KH₂ by the selected bacterial VKORHs in FIXgla-PCNKOR-Y139F/AV12 cells. VKORHs were transiently expressed in FIXgla-PC/HEK293 cells and the enzymatic activity was determined as described in FIG. 15.

FIGS. 22A-B. Proposed reaction mechanism of MT-VKORH in the reduction of ubiquinone and vitamin K. (A) Proposed reaction mechanism of MT-VKORH in E. coli protein disulfide bond formation. When a nascent peptide folds to a disulfide linked mature protein, a disulfide bond in the active site of DsbA is reduced to two free cysteines. These cysteines reduce the disulfide bond of the conserved loop cysteines (C57 and C65) of MT-VKORH and in turn those sulfhydryls participate in the intra-molecular reduction of the CXXC redox center. When ubiquinone is reduced to ubquinol by MT-VKORH, the CXXC active site cysteines are oxidized back to a disulfide bond. (B) Proposed reaction mechanism of MT-VKORH for reducing vitamin K in mammalian cells. The MT-VKORH disulfide bond of the CXXC active site is directly reduced by an unknown reductant. The reduced form of the enzyme can apparently reduce both KO and vitamin K for VKD carboxylation in mammalian cells.

FIG. 23. Effect of exchange of FLAG tag with cysteine loop on VKOR activity. The VKOR cysteine loop sequence D44VGTAIS50 (amino acids 44-50 of the amino acid sequence of VKOR as provided, for example as GenBank® Database Accession No. AAS01052) was replaced with FLAG tag sequence DYKDDDDK and the resulting protein was tested for carboxylation activity as described herein.

FIG. 24. Human-Synechococcus VKOR alignment.

FIG. 25. Mycobacterium tuberculosis-human VKOR alignment.

FIG. 26. M. tuberculosis-Synechococcus VKOR alignment.

FIG. 27. ELISA of VKOR activity among diverse species. (A) 48 h incubation with 5 μM warfarin, FIXgla-PC HEK293 cell line (300W/well, x-fect). (B) 48 h incubation with 5 μM KO, 4 μM warfarin, FIXgla-PC HEK293 cell line (300W/well, x-fect).

FIGS. 28A-B. Motifs found by Meme Suite. (A) Species used were: human, Mycobacterium tuberculosum, Salinaspora tropica and Nematostella vectensis. (B) Sachoglossus, Acropora, Xenopus, Amphioxus, Nematostella, human, Fugu, Ciona, zebra finch (strongest motif). Also included in the training set (but not picked as having the motif) were Conexibacter, Synechococcus, Prochlorococcus, Roseiflexus. Arrows mark small XXX small motif, often found in transmembrane (TM) domains.

FIGS. 29A-B. Transmembrane domain models of VKOR (A) 3-TMD Model. N-terminus: ER lumen, Cys 43 and 51: Cytoplasm. (B) 4-TMD Model. N-terminus: Cytoplasm, Cys 43 and 51: ER lumen.

FIGS. 30A-B. Positive Inside Rule. The orientation of the transmembrane helix is primarily determined by the charged residues flanking the hydrophobic core. (A) Positively charged residues are four times more abundant on the cytoplasmic side (inside) of membrane proteins as compared to the trans side. (B) Moving of the positively charged residue from the cytoplasmic side to the ER luminal side can result in inversion of TMD orientation.

FIGS. 31A-C. Changing the charge distributions flanking TMD1 may alter the membrane topology of human VKOR. (A) Arrows show residues modified to alter charge. (B) TMHMM prediction of human VKOR membrane topology-wild type VKOR. (C) TMHMM prediction of human VKOR membrane topology-charge-mutated (CM) VKOR

FIG. 32 Relative activity of charge-mutated VKOR (VKOR-CM) compared to control VKOR.

FIG. 33. Activity of human VKOR modified by a V45N substitution, which introduces an additional glycosylation site. Δ6 charge describes a human VKOR modified at six amino acid residues to alter the charge of the protein as described herein.

FIG. 34. Sequence alignments of VKOR amino acid sequences of several diverse species.

DETAILED DESCRIPTION OF THE INVENTION

This description is not intended to be a detailed catalog of all the different ways in which the invention may be implemented, or all the features that may be added to the instant invention. For example, features illustrated with respect to one embodiment may be incorporated into other embodiments, and features illustrated with respect to a particular embodiment may be deleted from that embodiment. In addition, numerous variations and additions to the various embodiments suggested herein will be apparent to those skilled in the art in light of the instant disclosure, which do not depart from the instant invention. Hence, the following descriptions are intended to illustrate some particular embodiments of the invention, and not to exhaustively specify all permutations, combinations and variations thereof.

Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The terminology used in the description of the invention herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. All publications, patent applications, patents, and other references mentioned herein are incorporated by reference in their entirety.

In some aspects, the present invention is based on the unexpected discovery that recombinant VKOR proteins from highly divergent species can be employed in methods of making an activated (i.e., carboxylated or fully carboxylated) vitamin K dependent protein in a cell, and in some embodiments, with a resulting yield of the activated vitamin K dependent protein being at least about the same or in some cases even greater as compared with the yield of activated vitamin K dependent protein made in a cell (e.g., a control cell) containing a recombinant human VKOR protein (e.g., a wild type human VKOR). Thus, in one embodiment, the present invention provides a method of increasing the amount of carboxylated (e.g., fully carboxylated) vitamin K dependent protein in a cell, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein, a second nucleic acid comprising a heterologous nucleotide sequence encoding vitamin K epoxide reductase (VKOR), wherein the heterologous nucleic acid encoding VKOR comprises, consists essentially of or consists of a nucleotide sequence that encodes an amino acid sequence having at least about 19% identity but not greater than about 79% identity (e.g., about 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, 25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60% 61%, 62%, 63%, 64%, 65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, etc.) with the amino acid sequence of a human VKOR (e.g., the amino acid sequence of GenBank® Accession No. AAS01052), under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, thereby increasing the amount of carboxylated (e.g., fully carboxylated) vitamin K dependent protein in the cell.

Additionally provided herein is a method of increasing the carboxylation of a vitamin K dependent protein, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein, a second nucleic acid comprising a heterologous nucleotide sequence encoding vitamin K epoxide reductase (VKOR), wherein the heterologous nucleic acid encoding VKOR comprises, consists essentially of, or consists of a nucleotide sequence that encodes an amino acid sequence having at least 19% identity but not greater than about 79% identity (e.g., about 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, 25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60% 61%, 62%, 63%, 64%, 65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, etc.) with the amino acid sequence of a human VKOR (e.g., the amino acid sequence of GenBank® Accession No. AAS01052), under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, thereby increasing the carboxylation of the vitamin K dependent protein in the cell.

The present invention also provides a method of producing a carboxylated vitamin K dependent protein in a cell, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein, a second nucleic acid comprising a heterologous nucleotide sequence encoding vitamin K epoxide reductase (VKOR), wherein the heterologous nucleic acid encoding VKOR comprises, consists essentially of or consists of a nucleotide sequence that encodes an amino acid sequence having at least 19% identity but not greater than about 79% identity (e.g., about 15%, 16%, 17%, 18%, 19%, 20%, 21%, 22%, 23%, 24%, 25%, 26%, 27%, 28%, 29%, 30%, 31%, 32%, 33%, 34%, 35%, 36%, 37%, 38%, 39%, 40%, 41%, 42%, 43%, 44%, 45%, 46%, 47%, 48%, 49%, 50%, 51%, 52%, 53%, 54%, 55%, 56%, 57%, 58%, 59%, 60% 61%, 62%, 63%, 64%, 65%, 66%, 67%, 68%, 69%, 70%, 71%, 72%, 73%, 74%, 75%, 76%, 77%, 78%, 79%, 80%, etc.) with the amino acid sequence of a human VKOR (e.g., the amino acid sequence of GenBank® Accession No. AAS01052), under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, wherein the amount of carboxylated vitamin K dependent protein produced in the cell in the presence of VKOR produced by the second nucleic acid is increased as compared to the amount of carboxylated vitamin K dependent protein produced in the cell in the absence of VKOR produced by the second nucleic acid, thereby producing a carboxylated vitamin K dependent protein in the cell.

In further embodiments of the methods of this invention as described above, the heterologous nucleic acid encoding vitamin K epoxide reductase (VKOR; e.g., recombinant VKOR) can be, but is not limited to:

1) a nucleotide sequence that encodes an amino acid sequence having at least 19% identity but not greater than about 79% identity with the amino acid sequence of human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. AAS01052), including any variant of human VKOR;

2) a nucleotide sequence that encodes a Mycobacterium tuberculosis VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. NP 217484);

3) a nucleotide sequence that encodes an Acropora VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. EZ012735);

4) a nucleotide sequence that encodes a Nematostella VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. XP_(—)001627634);

5) a nucleotide sequence that encodes an Amphioxus VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. XP_(—)002611989nucleotide sequence: GenBank® Accession No. XM_(—)001611843);

6) a nucleotide sequence that encodes a Takifugu VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. NP_(—)001027838);

7) a nucleotide sequence that encodes a Ciona VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. NP_(—)001073142);

8) a nucleotide sequence that encodes a hamster VKOR (non limiting examples of which include the VKOR having the amino acid sequence of SEQ ID NO:X obtained from Syrian golden hamster cell line MCB3901 [AV12-664]; Accession No. CRL-9595 and the VKOR having the amino acid sequence provided as GenBank® Accession No. XP_(—)003511033.1);

9) a nucleotide sequence that encodes a Drosophila VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. NP_(—)001014533);

10) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. AAS01052), comprising a C51A mutation;

11) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. AAS01052), comprising an IV133-134PY mutation;

12) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. AAS01052), comprising a C51A mutation and an IV133-134PY mutation;

13) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052), comprising a V45N mutation;

14) a nucleotide sequence that encodes a human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence provided as GenBank® Accession No. AAS01052), comprising a substitution of amino acids 44-50 with amino acids DYKDDDDK;

15) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. AAS01052) with amino acids 129-146 (FQSLYRIGALCPYCMVVW) of Mycobacterium tuberculosis VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. NP_(—)217484);

16) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. AAS01052) with amino acids 185-202 (ILSTKLSGSSCLYCLVSA) of Arabidopsis VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. NP_(—)567988);

17) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. AAS01052) with amino acids 120-137 (YLMVAVLRQFCMYCTTAI) of Synechococcus VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. YP_(—)478481);

18) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. AAS01052) with amino acids 33-50 (WFQHVMLLKPCVLCIYER) of a bacterial DsbB enzyme a nonlimiting example of which is the DsbB enzyme having the amino acid sequence set forth as (GenBank® Accession No. ZP_(—)03067529); and/or

19) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 123-139 (WILFFVLYDFCIVCITTY) of human VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as GenBank® Accession No. AAS01052) with amino acids 300-317 (FLEPFVIGATCLWCLTSA) of Roseiflexus VKOR (a nonlimiting example of which is the VKOR having the amino acid sequence set forth as QenBank® Accession No, YP_(—)001274867).

In some embodiments of the methods described herein, the cell can further comprise a third nucleic acid, comprising, consisting essentially of or consisting of a nucleotide sequence encoding vitamin K dependent gamma carboxylase (VKGC). The nucleotide sequence and amino acid sequence of the vitamin K dependent gamma carboxylase protein of a variety of species are well known to one of skill in the art and readily accessible via publicly accessible databases such as the GenBank® Database.

In some embodiments, the vitamin K dependent protein of this invention can be a coagulation factor, which can be, but is not limited to Factor VII, Factor IX, Factor X, Protein C, Protein S, prothrombin and any combination thereof. Vitamin K dependent proteins are well known in the art. The nucleotide sequence and amino acid sequence of numerous vitamin K dependent proteins are well known to one of skill in the art and readily accessible via publicly accessible databases such as the GenBank® Database.

An additional aspect of the present invention is a recombinant nucleic acid comprising a nucleotide sequence encoding vitamin K epoxide reductase (VKOR) as described herein operatively associated with a heterologous promoter. Such a recombinant nucleic acid can be present in a cell (e.g., a transformed cell). Thus, a further aspect of the present invention is a cell that contains and expresses a recombinant nucleic acid as described above. Such a cell can be a transformed cell. Suitable cells of this invention include but are not limited to, plant, animal, mammal, insect, yeast and bacterial cells.

In some embodiments of the methods of this invention, when the cell is a plant cell or an insect cell, the first nucleic acid encoding the vitamin K dependent protein can be a heterologous nucleic acid. The production of a heterologous nucleic acid encoding a vitamin K dependent protein and introduction of such heterologous nucleic acid into a cell to produce a recombinant vitamin K dependent protein in the cell are well known in the art.

In some embodiments of the methods of this invention, when the cell is a mammalian cell, the first nucleic acid encoding the vitamin K dependent protein can be a heterologous nucleic acid and/or an endogenous nucleic acid. For example, the mammalian cell can endogenously produce the vitamin K dependent protein of interest and that endogenously produced vitamin K dependent protein is what is activated when recombinant VKOR is present in the mammalian cell. In some embodiments, the mammalian cell can comprise an endogenously produced vitamin k dependent protein and a heterologous (e.g., recombinant) vitamin K dependent protein, both of which can be activated when recombinant VKOR is present in the mammalian cell.

FIG. 9 shows sequence alignments of the amino acid sequence of the VKOR protein from rat, mouse, human, zebrafish (Danio sp.), Fugu fish (Takifugu sp.), Xenopus, Acropora, Nematostella, Amphioxus, Ciona, mosquito (Anopheles sp.), fly (Drosophila sp.), and M. tuberculosis. The percent identities for these sequences relative to human VKOR are set forth in Table 1. As explained herein, the present invention demonstrates that recombinant VKOR from widely divergent species (e.g., M. tuberculosis with only about 19% identity with human VKOR) can be used to activate vitamin K dependent proteins in cells.

In further aspects, the present invention is based on the unexpected discovery that modifying or mutating a human VKOR protein by changing the charge distribution of various residues on either side of the first transmembrane domain results in a VKOR protein with increased ability to produce carboxylated (e.g., fully carboxylated) vitamin K dependent proteins. Thus, in one embodiment, the present invention provides a method of increasing the amount of carboxylated vitamin K dependent protein in a cell, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein a second nucleic acid comprising a heterologous nucleotide sequence encoding a human vitamin K epoxide reductase (VKOR), (e.g., identified as having the amino acid sequence of GenBank® Database Accession No. AAS01052), comprising an R37G mutation, an R35G mutation, an R33G mutation, a K30i mutation, a G9R mutation, a S7R mutation and a G6R mutation, under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, thereby increasing the amount of carboxylated vitamin K dependent protein in the cell.

A further embodiment of the present invention is a method of increasing the carboxylation of a vitamin K dependent protein, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein, a second nucleic acid comprising a heterologous nucleotide sequence encoding a human vitamin K epoxide reductase (VKOR), (e.g., identified as having the amino acid sequence of GenBank® Database Accession No. AAS01052), comprising an R37G mutation, an R35G mutation, an R33G mutation, a K30L mutation, a G9R mutation, a S7R mutation and a G6R mutation, under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, thereby increasing the carboxylation of the vitamin K dependent protein in the cell.

An additional embodiment of this invention is a method of producing a carboxylated (e.g., fully carboxylated) vitamin K dependent protein in a cell, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein, a second nucleic acid comprising a heterologous nucleotide sequence encoding a human vitamin K epoxide reductase (VKOR), (e.g., identified as having the amino acid sequence of GenBank® Database Accession No. AAS01052), comprising an R37G mutation, an R35G mutation, an R33G mutation, a K30L mutation, a G9R mutation, a S7R mutation and a G6R mutation, under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, wherein the amount of carboxylated vitamin K dependent protein produced in the cell in the presence of VKOR produced by the second nucleic acid is increased as compared to the amount of carboxylated vitamin K dependent protein produced in the cell in the absence of VKOR produced by the second nucleic acid, thereby producing a carboxylated vitamin K dependent protein in the cell.

As noted herein, aspects of the present invention are based on the discovery that modification of the charge distribution of various residues on either side of the first transmembrane domain of a human VKOR amino acid sequence can alter the activity of the modified VKOR, resulting, in particular embodiments, in an increased capability of the modified VKOR protein to produce carboxylated vitamin K dependent proteins, as compared with the capability of a nonmodified (e.g., wild type human VKOR sequence or a human VKOR sequence lacking modifications to residues 6, 7, 9, 30, 33, 35 and/or 37 as described herein; amino acid numbering based on the amino acid sequence of human VKOR having GenBank Accession No. AAS01052).

Thus additional embodiments of the present invention include a human VKOR comprising an R37G mutation, an R35G mutation, an R33G mutation, a K30L mutation, a G9R mutation, a S7R mutation and/or a G6R mutation in any combination. Furthermore, the amino acid substitution at residues R37, R35 and/or R33 can be a glycine as described above, or the amino acid substitution at these residues can be with a different amino acid residue that results in the same or a similar effect on charge distribution. For example, glycine is a nonpolar amino acid so substitution at R37, R35 and/or R33 can be done with a different nonpolar amino acid (e.g., alanine (A), valine (V), leucine (L), isoleucine (I), methionine (M), phenylalanine (F), tryptophan (W) or proline (P)).

In yet further embodiments, the human VKOR of this invention can be substituted at K30 with a leucine (L) as described herein, or the substitution at K30 can be with a different amino acid residue that results in the same or similar effect on charge distribution. For example, leucine is a nonpolar amino acid so substitution at K30 can be done with a different nonpolar amino acid (e.g., alanine (A), valine (V), glycine (G), isoleucine (I), methionine (M), phenylalanine (F), tryptophan (W) or proline (P)).

The human VKOR of this invention can also be substituted at G9 and/or G6 with an arginine (R) as described herein, or the substitution at G9 and or G6 can be with a different amino acid residue that results in the same or similar effect on charge distribution. For example, arginine (R) is a positively charged or polar amino acid so substitution at G9 and/or G6 can be with a different positively charged or polar amino acid (e.g., histidine (H), lysine (K), serine (S), threonine (T), cysteine (C), tyrosine (Y), asparagine (N) or glutamine (Q)).

In further embodiments, the human VKOR of this invention can be substituted at S7 with an arginine (R) as described herein or the substitution at S7 can be with a different amino acid residue that results in the same or similar effect on charge distribution. For example, arginine (R) is a positively charged or polar amino acid so substitution at S7 can be with a different positively charged or polar amino acid (e.g., histidine (H), lysine (K), threonine (T), cysteine (C), tyrosine (Y), asparagine (N) or glutamine (Q).

It is also contemplated in this invention that eliminating the positive charges and even possibly introducing negative charges just carboxy-terminal to the first transmembrane domain and/or introducing negative charges into the loop structure (e.g., the loop comprising C43 and C51) of the human VKOR protein could be as effective or even more effective in enhancing the carboxylating activity of VKOR as compared with the amino acid substitutions described herein. Before the first transmembrane domain, the amino terminal portion of all metazoan VKOR molecules is very heterogeneous, making it likely that many additional changes can be made in the amino terminus without hindering the ability of VKOR to stimulate carboxylation. The production and testing of such mutants would be well within the skill in the art.

In various embodiments of this invention, any of the amino acid residue substitutions described herein can be present in any combination in a human VKOR protein of this invention. In particular embodiments, the amino acid residue substitutions described herein can be present in any combination in a human VKOR protein of this invention, wherein the result of the combination of amino acid residue substitutions is a VKOR protein having increased carboxylating activity as compared with a VKOR protein lacking the combination of amino acid residue substitutions. The production and analysis of any of the VKOR proteins of this invention having any of the combinations of amino acid residue substitutions can be carried out according to standard protocols well known in the art. For example, the carboxylating activity of a VKOR protein of this invention can be analyzed and measured according to protocols as set forth, for example in Tie et al. “Functional study of the vitamin K cycle in mammalian cells” Blood 117:2967-2974 (Jan. 14, 2011) and Tie et al. “Mycobacterium tuberculosis vitamin K epoxide reductase homologue supports vitamin K-dependent carboxylation in mammalian cells” Antioxid Redox Signal, e-published Sep. 22, 2011, the entire contents of each of which are incorporated by reference herein.

In some embodiments of the methods described herein, the cell can further comprise a third nucleic acid, comprising, consisting essentially of or consisting of a nucleotide sequence encoding vitamin K dependent gamma carboxylase (VKGC). The nucleotide sequence and amino acid sequence of the vitamin K dependent gamma carboxylase protein of a variety of species are well known to one of skill in the art and readily accessible via publicly accessible databases such as the GenBank® Database.

In some embodiments, the vitamin K dependent protein of this invention can be a coagulation factor, which can be, but is not limited to Factor VII, Factor IX, Factor X, Protein C, Protein S, prothrombin and any combination thereof. Vitamin K dependent proteins are well known in the art. The nucleotide sequence and amino acid sequence of numerous vitamin K dependent proteins are well known to one of skill in the art and readily accessible via publicly accessible databases such as the GenBank® Database.

An additional aspect of the present invention is a recombinant nucleic acid comprising a nucleotide sequence encoding vitamin K epoxide reductase (VKOR) as described herein operatively associated with a heterologous promoter. Such a recombinant nucleic acid can be present in a cell (e.g., a transformed cell). Thus, a further aspect of the present invention is a cell that contains and expresses a recombinant nucleic acid as described above. Such a cell can be a transformed cell. Suitable cells of this invention include but are not limited to, plant, animal, mammal, insect, yeast and bacterial cells.

In some embodiments of the methods of this invention, when the cell is a plant cell or an insect cell, the first nucleic acid encoding the vitamin K dependent protein can be a heterologous nucleic acid. The production of a heterologous nucleic acid encoding a vitamin K dependent protein and introduction of such heterologous nucleic acid into a cell to produce a recombinant vitamin K dependent protein in the cell are well known in the art.

In some embodiments of the methods of this invention, when the cell is a mammalian cell, the first nucleic acid encoding the vitamin K dependent protein can be a heterologous nucleic acid and/or an endogenous nucleic acid. For example, the mammalian cell can endogenously produce the vitamin K dependent protein of interest and that endogenously produced vitamin K dependent protein is what is activated when recombinant VKOR is present in the mammalian cell. In some embodiments, the mammalian cell can comprise an endogenously produced vitamin k dependent protein and a heterologous (e.g., recombinant) vitamin K dependent protein, both of which can be activated when recombinant VKOR is present in the mammalian cell.

DEFINITIONS

As used herein, “a,” “an” or “the” can mean one or more than one. For example, a cell can mean a single cell or a multiplicity of cells.

As used herein, “and/or” refers to and encompasses any and all possible combinations of one or more of the associated listed items, as well as the lack of combinations when interpreted in the alternative (or).

Further, the term “about,” as used herein when referring to a measurable value such as an amount of a compound or agent, dose, time, temperature, and the like, is meant to encompass variations of ±20%, ±10%, ±5%, ±1%, +0.5%, or even 0.1% of the specified amount.

As used herein, the transitional phrase “consisting essentially of” means that the scope of a claim is to be interpreted to encompass the specified materials or steps recited in the claim and those that do not materially affect the basic and novel characteristic(s) of the claimed invention. Thus, the term “consisting essentially of” when used in a claim of this invention is not intended to be interpreted to be equivalent to “comprising.”

The term “consisting essentially of” (and grammatical variants), as applied to a polynucleotide or polypeptide sequence of this invention, means a polynucleotide or polypeptide that consists of both the recited sequence (e.g., SEQ ID NO) and a total of ten or less (e.g., 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10) additional nucleotides or amino acids on the 5′ and/or 3′ or N-terminal and/or C-terminal ends of the recited sequence such that the function of the polynucleotide or polypeptide is not materially altered. The total of ten or less additional nucleotides or amino acids includes the total number of additional nucleotides or amino acids on both ends added together. The term “materially altered,” as applied to polynucleotides of the invention, refers to an increase or decrease in ability to express the encoded polypeptide of at least about 50% or more as compared to the expression level of a polynucleotide consisting of the recited sequence. The term “materially altered,” as applied to polypeptides of the invention, refers to an increase or decrease in angiogenesis-stimulating activity of at least about 50% or more as compared to the activity of a polypeptide consisting of the recited sequence.

As used herein, the term “nucleic acid,” “nucleic acid molecule” and “nucleotide sequence” encompass both RNA and DNA, including cDNA, genomic DNA, synthetic (e.g., chemically synthesized) DNA and chimeras of RNA and DNA. The nucleic acid molecule or nucleotide sequence may be double-stranded or single-stranded. Where single-stranded, the nucleic acid molecule may be a sense strand or an antisense strand. The nucleic acid molecule may be synthesized using oligonucleotide analogs or derivatives (e.g., inosine or phosphorothioate nucleotides). Such oligonucleotides can be used, for example, to prepare nucleic acid molecules or nucleotide sequences that have altered base-pairing abilities or increased resistance to nucleases.

An “isolated nucleic acid” or “isolated nucleotide sequence” is a DNA or RNA that is not immediately contiguous with both of the coding sequences with which it is immediately contiguous (one on the 5′ end and one on the 3′ end) in the naturally occurring genome of the organism from which it is derived. Thus, in one embodiment, an isolated nucleic acid or nucleotide sequence includes some or all of the 5′ non-coding (e.g., promoter) sequences that are immediately contiguous to the coding sequence. The term therefore includes, for example, a recombinant DNA that is incorporated into a vector, into an autonomously replicating plasmid or virus, or into the genomic DNA of a prokaryote or eukaryote, or which exists as a separate molecule (e.g., a cDNA or a genomic DNA fragment produced by PCR or restriction endonuclease treatment), independent of other sequences. It also includes a recombinant DNA that is part of a hybrid gene encoding an additional polypeptide sequence.

The term “isolated” can refer to a nucleic acid, nucleotide sequence or polypeptide that is substantially free of cellular material, viral material, or culture medium (when produced by recombinant DNA techniques), or chemical precursors or other chemicals (when chemically synthesized). Moreover, an “isolated nucleic acid fragment” is a nucleic acid fragment that is not naturally occurring as a fragment and would not be found in the natural state. “Isolated” does not mean that the preparation is technically pure (homogeneous), but it is sufficiently pure to provide the polypeptide or nucleic acid in a form in which it can be used for the intended purpose. Furthermore, an “isolated cell” is a cell that has been separated from other components with which it is normally associated in nature. For example, an isolated cell can be a cell in culture medium and/or a cell in a pharmaceutically acceptable carrier of this invention.

The term “oligonucleotide” refers to a nucleotide sequence of at least about five nucleotides to about 300 nucleotides, for example, about 15 to 30 nucleotides, or about 20 to 25 nucleotides, which can be used, for example, as a primer in a PCR amplification and/or as a probe in a hybridization assay or in a microarray. Oligonucleotides may be natural or synthetic, e.g., DNA, RNA, modified backbones, etc.

The term “stringent” as used here refers to hybridization conditions that are commonly understood in the art to define the commodities of the hybridization procedure. Stringency conditions can be low, high or medium, as those terms are commonly know in the art and well recognized by one of ordinary skill. High stringency hybridization conditions that will permit homologous nucleotide sequences to hybridize to a nucleotide sequence as given herein are well known in the art. As one example, hybridization of such sequences to the nucleic acid molecules disclosed herein can be carried out in 25% formamide, 5×SSC, 5×Denhardt's solution and 5% dextran sulfate at 42° C., with wash conditions of 25% formamide, 5×SSC and 0.1% SDS at 42° C., to allow hybridization of sequences of about 60% homology. Another example includes hybridization conditions of 6×SSC, 0.1% SDS at about 45° C., followed by wash conditions of 0.2×SSC, 0.1% SDS at 50-65° C. Another example of stringent conditions is represented by a wash stringency of 0.3 M NaCl, 0.03M sodium citrate, 0.1% SDS at 60-70° C. using a standard hybridization assay (see SAMBROOK et al., EDS., MOLECULAR CLONING: A LABORATORY MANUAL 2d ed. (Cold Spring Harbor, N.Y. 1989, the entire contents of which are incorporated by reference herein). In various embodiments, stringent conditions can include, for example, highly stringent (i.e., high stringency) conditions (e.g., hybridization to filter-bound DNA in 0.5 M NaHPO₄, 7% sodium dodecyl sulfate (SDS), 1 mM EDTA at 65° C., and washing in 0.1×SSC/0.1% SDS at 68° C.), and/or moderately stringent (i.e., medium stringency) conditions (e.g., washing in 0.2×SSC/0.1% SDS at 42° C.).

Where a particular nucleotide sequence is said to have a specific percent identity to a reference nucleotide sequence, the percent identity is relative to the reference nucleotide sequence. For example, a nucleotide sequence that is 50%, 75%, 85%, 90%, 95% or 99% identical to a reference nucleotide sequence that is 100 bases long can have 50, 75, 85, 90, 95 or 99 bases that are completely identical to a 50, 75, 85, 90, 95 or 99 nucleotide sequence of the reference nucleotide sequence. The nucleotide sequence can also be a 100 base long nucleotide sequence that is 50%, 75%, 85%, 90%, 95% or 99% identical to the reference nucleotide sequence over its entire length. Of course, there are other nucleotide sequences that will also meet the same criteria.

A nucleic acid molecule or nucleotide sequence that is “substantially identical” to a VKOR nucleotide sequence is at least 70%, 75%, 80%, 85% 90%, 95% or 99% identical to the nucleotide sequence encoding a VKOR protein of this invention. For purposes of comparison of nucleic acids, the length of the reference nucleic acid sequence will generally be at least 40 nucleotides, e.g., at least 60 nucleotides or more nucleotides. Sequence identity can be measured using sequence analysis software (e.g., Sequence Analysis Software Package of the Genetics Computer Group, University of Wisconsin Biotechnology Center, 1710 University Avenue, Madison, Wis. 53705).

Furthermore, where a particular amino acid sequence is said to have a specific percent identity to a reference amino acid sequence, the percent identity is relative to the reference amino acid sequence. For example, an amino acid sequence that is 10%, 20%, 30%, 40%, 50%, 75%, 85%, 90%, 95% or 99% identical to a reference amino acid sequence that is 100 amino acid residues long can have 50, 75, 85, 90, 95 or 99 residues that are completely identical to a 50, 75, 85, 90, 95 or 99 residue sequence of the reference amino acid sequence. The amino acid sequence can also be a 100 residue long amino acid sequence that is 50%, 75%, 85%, 90%, 95% or 99% identical to the reference amino acid sequence over its entire length.

As is known in the art, a number of different programs can be used to identify whether a nucleic acid or amino acid has sequence identity or similarity to a known sequence. Sequence identity or similarity may be determined using standard techniques known in the art, including, but not limited to, the local sequence identity algorithm of Smith & Waterman, Adv. Appl. Math. 2, 482 (1981), by the sequence identity alignment algorithm of Needleman & Wunsch, J. Mol. Biol. 48,443 (1970), by the search for similarity method of Pearson & Lipman, Proc. Natl. Acad. Sci. USA 85:2444 (1988), by computerized implementations of these algorithms (GAP, BESTFIT, FASTA, and TFASTA in the Wisconsin Genetics Software Package, Genetics Computer Group, 575 Science Drive, Madison, Wis.), the Best Fit sequence program described by Devereux et al., Nucl. Acid Res. 12, 387-395 (1984), preferably using the default settings, or by inspection.

An example of a useful algorithm is PILEUP. PILEUP creates a multiple sequence alignment from a group of related sequences using progressive, pairwise alignments. It can also plot a tree showing the clustering relationships used to create the alignment. PILEUP uses a simplification of the progressive alignment method of Feng & Doolittle, J. Mol. Evol. 35, 351-360 (1987); the method is similar to that described by Higgins & Sharp, CABIOS 5:151-153 (1989).

Another example of a useful algorithm is the BLAST algorithm, described in Altschul et al., J. Mol. Biol. 215, 403-410, (1990) and Karlin et al., Proc. Natl. Acad. Sci. USA 90, 5873-5787 (1993). A particularly useful BLAST program is the WU-BLAST-2 program that was obtained from Altschul et al., Methods in Enzymology, 266, 460-480 (1996). WU-BLAST-2 uses several search parameters, which are preferably set to the default values. The parameters are dynamic values and are established by the program itself depending upon the composition of the particular sequence and composition of the particular database against which the sequence of interest is being searched; however, the values may be adjusted to increase sensitivity. An additional useful algorithm is gapped BLAST as reported by Altschul et al. Nucleic Acids Res. 25, 3389-3402.

The CLUSTAL program can also be used to determine sequence similarity. This algorithm is described by Higgins et al. (1988) Gene 73:237; Higgins et al. (1989) CABIOS 5:151-153; Corpet et al. (1988) Nucleic Acids Res. 16: 10881-90; Huang et al., (1992) CABIOS 8: 155-65; and Pearson et al. (1994) Meth. Mol. Biol. 24: 307-331.

In addition, for sequences that contain either more or fewer nucleotides than the nucleic acids disclosed herein, it is understood that in one embodiment, the percentage of sequence identity will be determined based on the number of identical nucleotides in relation to the total number of nucleotide bases. Thus, for example, sequence identity of sequences shorter than a sequence specifically disclosed herein will be determined using the number of nucleotide bases in the shorter sequence, in one embodiment. In percent identity calculations, relative weight is not assigned to various manifestations of sequence variation, such as, insertions, deletions, substitutions, etc.

The VKOR polypeptides of the invention include, but are not limited to, recombinant polypeptides, synthetic peptides and natural polypeptides. The invention also encompasses nucleic acid sequences that encode forms of VKOR polypeptides in which naturally occurring amino acid sequences are altered or deleted. Preferred nucleic acids encode polypeptides that are soluble under normal physiological conditions. Also within the invention are nucleic acids encoding fusion proteins in which all or a portion of VKOR is fused to an unrelated polypeptide (e.g., a marker polypeptide or a fusion partner) to create a fusion protein. For example, the polypeptide can be fused to a hexa-histidine tag to facilitate purification of bacterially expressed polypeptides, or to a hemagglutinin tag to facilitate purification of polypeptides expressed in eukaryotic cells, or to an HPC4 tag to facilitate purification of polypeptides by affinity chromatography or immunoprecipitation. The invention also includes isolated polypeptides (and the nucleic acids that encode these polypeptides) that include a first portion and a second portion; the first portion includes, e.g., all or a portion of a VKOR polypeptide, and the second portion includes, e.g., a detectable marker.

Furthermore, the vitamin K dependent proteins of the invention include, but are not limited to, recombinant polypeptides, synthetic peptides and natural polypeptides. The invention also encompasses nucleic acid sequences that encode forms of vitamin K dependent proteins in which naturally occurring amino acid sequences are altered or deleted. Preferred nucleic acids encode polypeptides that are soluble under normal physiological conditions. Also within the invention are nucleic acids encoding fusion proteins in which all or a portion of vitamin K dependent protein is fused to an unrelated polypeptide (e.g., a marker polypeptide or a fusion partner) to create a fusion protein. For example, the polypeptide can be fused to a hexa-histidine tag to facilitate purification of bacterially expressed polypeptides, or to a hemagglutinin tag to facilitate purification of polypeptides expressed in eukaryotic cells, or to an HPC4 tag to facilitate purification of polypeptides by affinity chromatography or immunoprecipitation. The invention also includes isolated polypeptides (and the nucleic acids that encode these polypeptides) that include a first portion and a second portion; the first portion includes, e.g., all or a portion of a vitamin K dependent protein, and the second portion includes, e.g., a detectable marker.

The fusion partner can be, for example, a polypeptide that facilitates secretion, e.g., a secretory sequence. Such a fused polypeptide is typically referred to as a preprotein. The secretory sequence can be cleaved by the cell to form the mature protein. Also included within the present invention is a nucleotide sequence that encodes VKOR or a vitamin K dependent protein fused to a polypeptide sequence to produce an inactive preprotein. Preproteins can be converted into the active form of the protein by removal of the inactivating sequence.

The invention also includes nucleic acids that hybridize, e.g., under stringent hybridization conditions (as defined herein) to all or a portion of the nucleotide sequence of a VKOR protein of this invention or its complementary sequence. In particular embodiments, the hybridizing portion of the hybridizing nucleic acid is typically at least 15 (e.g., 20, 30, or 50) nucleotides in length. The hybridizing portion of the hybridizing nucleic acid is at least 80%, e.g., at least 95%, at least 98% or 100%, identical to the sequence of a portion or all of a nucleic acid encoding a VKOR polypeptide. Hybridizing nucleic acids of the type described herein can be used, for example, as a cloning probe, a primer (e.g., a PCR primer), or a diagnostic probe. Also included within the invention are small inhibitory RNAs (siRNAs) and/or antisense RNAs that inhibit the function of VKOR, as determined, for example, in an activity assay, as described herein and as is known in the art.

In another embodiment, the invention features cells, e.g., transformed cells, which contain a nucleic acid molecule or nucleotide sequence of this invention. A “transformed cell” is a cell into which (or into an ancestor of which) has been introduced, by means of recombinant nucleic acid techniques, a nucleic acid encoding all or a part of a VKOR polypeptide, and/or a vitamin K dependent protein. Both prokaryotic and eukaryotic cells are included, e.g., bacteria, yeast, insect, mouse, rat, human, plant and the like.

The term “transformation” as used herein refers to the introduction of a heterologous nucleic acid into a cell. Transformation of a cell may be stable or transient. The term “transient transformation” or “transiently transformed” refers to the introduction of one or more heterologous nucleic acids into a cell wherein the heterologous nucleic acid is not heritable from one generation to another.

“Stable transformation” or “stably transformed” refers to the integration of the heterologous nucleic acid into the genome of the cell or incorporation of the heterologous nucleic acid into the cell or cells (e.g., via a plasmid) such that the heterologous nucleic acid is heritable across repeated generations. Thus, in one embodiment of the present invention a stably transformed cell is produced.

Transient transformation may be detected by, for example, an enzyme-linked immunosorbent assay (ELISA) or Western blot, which can detect the presence of a peptide or polypeptide encoded by one or more transgene introduced into a cell. Stable transformation of a cell can be detected by, for example, a Southern blot hybridization assay of genomic DNA of the cell with nucleic acid sequences which specifically hybridize with a nucleotide sequence of a transgene introduced into a cell. Stable transformation of a cell can be detected by, for example, a Northern blot hybridization assay of RNA of the cell with nucleic acid sequences which specifically hybridize with a nucleotide sequence of a transgene introduced into a cell. Stable transformation of a cell can also be detected by, e.g., a polymerase chain reaction (PCR) or other amplification reactions as are well known in the art, employing specific primer sequences that hybridize with target sequence(s) of a transgene, resulting in amplification of the transgene sequence, which can be detected according to standard methods Transformation can also be detected by direct sequencing and/or hybridization protocols well known in the art.

The terms “exogenous” and/or “heterologous” as used herein can include a nucleotide sequence that is not naturally occurring in the nucleic acid construct and/or delivery vector (e.g., virus delivery vector) in which it is contained and can also include a nucleotide sequence that is placed into a non-naturally occurring environment and/or non-naturally occurring position relative to other nucleotide sequences (e.g., by association with a promoter or coding sequence with which it is not naturally associated). For example, a cell of this invention can comprise a heterologous nucleotide sequence encoding a VKOR protein and/or vitamin K dependent protein and said cell can also produce the VKOR protein and/or vitamin K dependent protein endogenously. In other embodiments, a cell of this invention can comprise a heterologous nucleotide sequence encoding a VKOR protein and/or vitamin K dependent protein and said cell may not produce the VKOR protein and/or vitamin K dependent protein endogenously.

The invention also features nucleic acid constructs (e.g., vectors and plasmids) that include a nucleic acid molecule or nucleotide sequence of the invention that is operably linked to a transcription and/or translation control element to enable expression, e.g., expression vectors. By “operably linked” is meant that a selected nucleic acid, e.g., a DNA molecule encoding a VKOR polypeptide and/or a vitamin K dependent protein, is positioned adjacent to one or more regulatory elements, e.g., a promoter, which directs transcription and/or translation of the sequence such that the regulatory elements can control transcription and/or translation of the selected nucleic acid.

The present invention further provides fragments or oligonucleotides of the nucleic acids of this invention, which can be used as primers or probes. Thus, in some embodiments, a fragment or oligonucleotide of this invention is a nucleotide sequence that is at least 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70, 75, 80, 85, 90, 100, 125, 150, 175, 200, 250, 300, 350, 400, 450, 500, 550, 600, 650, 700, 750, 800, 850, 900, 1000, 1500, 2000, 2500 or 3000 contiguous nucleotides of a nucleotide sequence encoding a VKOR or vitamin K dependent protein of this invention. Such fragments or oligonucleotides can be detectably labeled or modified, for example, to include and/or incorporate a restriction enzyme cleavage site when employed as a primer in an amplification (e.g., PCR) assay.

The invention also features purified or isolated VKOR polypeptides, such as, for example, a polypeptide comprising, consisting essentially of and/or consisting of the amino acid sequence of the VKOR proteins as described herein or a biologically active fragment or peptide thereof. Such fragments or peptides are typically at least about ten amino acids of the amino acid sequence of a VKOR protein of this invention, (e.g., 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 75, 85, 95, 100, 125, or 150 amino acids of the amino acid sequence of a VKOR protein of this invention and can be a peptide or fragment of contiguous amino acids of the amino acid sequence of the VKOR protein of this invention. A “biologically active” fragment or peptide of a VKOR protein of this invention is a fragment or peptide of the VKOR protein that has 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 100%, etc. activity as compared with a human VKOR protein of this invention. The biological activity of a fragment or peptide of this invention can be determined according to the methods provided herein and as are known in the art for identifying VKOR activity. The fragments and peptides of the VKOR protein of this invention can also be active as antigens for the production of antibodies. The identification of epitopes on a fragment or peptide of this invention is carried out by well known protocols and would be within the ordinary skill of one in the art.

As used herein, both “protein” and “polypeptide” mean any chain of amino acids, regardless of length or post-translational modification (e.g., glycosylation, phosphorylation or N-myristylation). Thus, the term “VKOR polypeptide” includes full-length, naturally occurring VKOR proteins, respectively, as well as recombinantly or synthetically produced polypeptides that correspond to a full-length, naturally occurring VKOR protein, or to a portion of a naturally occurring or synthetic VKOR polypeptide.

VKOR proteins of this invention can include a protein substantially identical to all or a portion of a naturally occurring VKOR protein and having VKOR activity as described herein. Proteins that are “substantially identical” to the VKOR proteins described herein have an amino acid sequence that is at least 70%, 75%, 80% or 85% (e.g., 90%, 95% or 99%) identical to the amino acid sequence of the VKOR protein of this invention.

In the case of proteins/polypeptide sequences that are less than 100% identical to a VKOR of this invention, the non-identical positions are preferably, but not necessarily, conservative substitutions for the amino acids of the reference VKOR sequence. Conservative substitutions are well known in the art and typically include, but are not limited to, substitutions within the following groups: glycine and alanine; valine, isoleucine, and leucine; aspartic acid and glutamic acid; asparagine and glutamine; serine and threonine; lysine and arginine; and phenylalanine and tyrosine. Modification of an amino acid sequence to introduce such substitutions is well known in the art, as is the ability to identify variant sequences that contain such substitutions.

A further aspect of the present invention is a method of making a vitamin K dependent protein, comprising culturing a cell that expresses a nucleic acid encoding a vitamin K dependent protein that, in the presence of vitamin K, produces a vitamin K dependent protein; and then harvesting the vitamin K dependent protein from the culture medium, wherein the cell comprises and expresses a heterologous nucleotide sequence encoding a vitamin K epoxide reductase (VKOR) of this invention, thereby producing VKOR. In some embodiments the cell further comprises and expresses a heterologous nucleic acid encoding vitamin K dependent gamma carboxylase, thereby producing vitamin K dependent gamma carboxylase as described herein. In some embodiments, the expression of the VKOR-encoding nucleic acid and the production of the recombinant VKOR of this invention causes the cell to produce greater levels of the vitamin K dependent protein and/or greater levels of active (e.g., fully carboxylated) vitamin K dependent protein than would be produced in the absence of the recombinant VKOR of this invention or in the absence of recombinant VKOR and recombinant vitamin K dependent gamma carboxylase.

Thus, in some embodiments, the present invention also provides a method of producing a vitamin K dependent protein, comprising:

a) introducing into a cell that comprises a nucleotide sequence that encodes a vitamin K dependent protein, a heterologous nucleic acid encoding a nucleic acid comprising a nucleotide sequence encoding a vitamin K epoxide reductase of this invention under conditions whereby the vitamin K dependent protein is produced in the presence of vitamin K and is carboxylated by the recombinant vitamin K epoxide reductase, and

b) optionally collecting the vitamin K dependent protein from the cell.

The present invention also provides a method of increasing the amount of carboxylated vitamin K dependent protein in a cell, comprising introducing into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein a second heterologous nucleic acid encoding a vitamin K epoxide reductase (VKOR) of this invention under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively.

Further provided herein is a method of increasing the carboxylation of a vitamin K dependent protein, comprising introducing into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein a second heterologous nucleic acid encoding a vitamin K epoxide reductase (VKOR) of this invention under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively.

In addition, the present invention provides a method of producing a carboxylated (e.g., fully carboxylated) vitamin K dependent protein in a cell, comprising introducing into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein a second heterologous nucleic acid encoding a vitamin K epoxide reductase (VKOR) of this invention under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, wherein the amount of carboxylated vitamin K dependent protein produced in the cell in the presence of VKOR produced from the heterologous nucleotide sequence is increased as compared to the amount of carboxylated vitamin K dependent protein produced in the cell in the absence of the VKOR of this invention produced from the heterologous nucleotide sequence.

Furthermore, the present invention provides a method of producing a vitamin K dependent protein in a cell, comprising introducing into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein a second nucleic acid comprising a heterologous nucleotide sequence encoding a vitamin K epoxide reductase (VKOR) of this invention under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, wherein 100%, 90%, 80%, 70% or 60% of the vitamin K dependent protein produced in the cell in the presence of VKOR is carboxylated (e.g., fully carboxylated).

Also included herein is a method of producing a vitamin K dependent protein in a cell, comprising introducing into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein a second nucleic acid comprising a heterologous nucleotide sequence encoding a vitamin K epoxide reductase (VKOR) of this invention under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively.

In some embodiments of the methods described above, the cell can further comprise a third nucleic acid encoding a vitamin K dependent carboxylase, which can be, but is not limited to, a bovine vitamin K dependent carboxylase. In particular embodiments, the vitamin K-dependent carboxylase is vitamin K gamma glutamyl carboxylase (VKGC). The VKGC used in the methods of this invention can be VKGC from any vertebrate or invertebrate species that produces VKGC, as are known in the art.

In methods of this invention where the amount of carboxylated vitamin K-dependent protein is increased in a cell in the presence of recombinant VKOR with or without recombinant VKGC, the amount of carboxylated or fully carboxylated vitamin K dependent protein produced in the cell in the presence of recombinant VKOR with or without recombinant VKGC can be increased at least about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90% 100% 125% 150%, 200% or 300%, as compared to the amount of carboxylated or fully carboxylated vitamin K dependent protein produced in the cell in the absence of recombinant VKOR with or without VKGC.

By “fully carboxylated” in some embodiments is meant that all sites (or in some embodiments, the majority of sites) on a vitamin K dependent protein that can undergo carboxylation are carboxylated. In some embodiments, fully carboxylated can mean that all vitamin K dependent proteins are carboxylated to some extent and/or that all vitamin K dependent proteins are carboxylated at all or at the majority of carboxylation sites. A carboxylated vitamin K dependent protein or fully carboxylated vitamin K dependent protein is an active or activated protein. By “active protein” or “activated protein” is meant that the vitamin K dependent protein has or is capable of activity in carrying out its biological function (e.g., an enzymatic activity for factor IX or factor X).

The vitamin K dependent protein that can be produced according to the methods of this invention can be any vitamin K dependent protein now known or later identified as such, including but not limited to, Factor VII, Factor VIIA, Factor IX, Factor X, Protein C, activated Protein C, Protein S, bone Gla protein (osteocalcin), matrix Gla protein and prothrombin, including modified versions of such proteins as described herein and as are well known in the art, in any combination.

Any cell that can be transformed with the nucleic acids described herein can be used as described herein, although in some embodiments non-human or even non-mammalian cells can be used. Thus, a cell or cell line of this invention can be, for example, a human cell, an animal cell, a plant cell and/or an insect cell. Nucleic acids encoding vitamin K dependent carboxylase and nucleic acids encoding vitamin K dependent proteins as described herein are well known in the art and their introduction into cells for expression would be carried out according to routine protocols. Thus, in some embodiments, the present invention provides a cell that comprises a nucleic acid (either endogenous or heterologous to the cell) that encodes a vitamin K dependent protein. The vitamin K dependent protein is produced in the cell in the presence of vitamin K. The cell further comprises a heterologous (i.e., exogenous) nucleic acid encoding a recombinant vitamin K epoxide reductase (VKOR) and in some embodiments also a heterologous nucleic acid encoding a recombinant vitamin K dependent carboxylase. The cell can be maintained under conditions known in the art whereby the nucleic acids encoding recombinant VKOR, and in some embodiments, recombinant vitamin K dependent carboxylase, are expressed and recombinant VKOR and in some embodiments, recombinant carboxylase are produced in the cell.

In further embodiments, the present invention provides a method of identifying a substance that regulates activity of Mycobacterium tuberculosis vitamin K epoxide reductase (VKOR), comprising determining the activity of Mycobacterium tuberculosis VKOR in the presence and absence of the substance by: a) contacting a recombinant Mycobacterium tuberculosis VKOR with a reporter protein under conditions whereby carboxylation of the reporter protein by the Mycobacterium tuberculosis VKOR can occur; and b) measuring the amount of carboxylation of the reporter protein by Mycobacterium tuberculosis VKOR in the presence and absence of the substance,

whereby an increase or decrease, respectively, in the amount of carboxylation of the reporter protein by Mycobacterium tuberculosis VKOR in the presence or absence, respectively, of the substance as compared to a control identifies the substance as a substance that regulates activity of Mycobacterium tuberculosis VKOR

Also provided herein is a method of identifying a substance for treating and/or preventing infection and/or disease caused by Mycobacterium tuberculosis, comprising determining the activity of Mycobacterium tuberculosis VKOR in the presence and absence of the substance by: a) contacting a recombinant Mycobacterium tuberculosis VKOR with a reporter protein under conditions whereby carboxylation of the reporter protein by the Mycobacterium tuberculosis VKOR can occur; and b) measuring the amount of carboxylation of the reporter protein by Mycobacterium tuberculosis VKOR in the presence and absence of the substance whereby a decrease in the amount of carboxylation of the reporter protein by Mycobacterium tuberculosis VKOR in the presence of the substance as compared to a control identifies the substance as a substance for treating and/or preventing infection and/or disease caused by Mycobacterium tuberculosis.

In the identifying methods described above, step (a) can be carried out in a cell-free system or in cells in culture and in some embodiments the cells can be mammalian cells, yeast cells, insect cells, etc., as are well known in the art. In some embodiments, the cells are mammalian cells, nonlimiting examples of which include HEK293 cells, AV12 cells, CHO cells, BHK cells, etc., as would be known to one of ordinary skill in the art.

Furthermore, in the methods of this invention, the reporter protein can be any protein that can be carboxylated by VKOR, e.g., any protein comprising a gla domain and propeptide (e.g., Factor VII, Factor IX, Factor X, Protein C, Protein S, prothrombin, Gus6, etc.), as are known in the art. In some embodiments, the reporter protein can be any protein comprising a gla domain and propeptide and/or a protein for which a gla-dependent conformational antibody can be produced. Nonlimiting examples of a reporter protein of this invention include Factor VII, Factor IX, Factor X, Protein C, Protein S, prothrombin, Gus6, Protein C comprising a gla domain and propeptide from Factor IX, protein C comprising a gla domain from Factor VII, protein C comprising a gla domain propeptide from Factor X, protein C comprising a gla domain propeptide from prothrombin, etc., as would be well known in the art.

In some embodiments of the methods of this invention, the amount of carboxylation of the reporter protein by Mycobacterium tuberculosis VKOR can be decreased by at least 10% as compared to control (e.g., by at least 5%, at least 10%, at least 15%, at least 20%, at least 25% at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 100% as compared to control).

In some embodiments of the methods of this invention, the amount of carboxylation of the reporter protein by Mycobacterium tuberculosis VKOR can be increased by at least 10% as compared to control (e.g., at least 5%, at least 10%, at least 15%, at least 20%, at least 25% at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 100%, at least 150%, at least 200%, at least 300%, at least 400%, at least 500%, as compared to control).

The present invention is more particularly described in the following examples that are intended as illustrative only since numerous modifications and variations therein will be apparent to those skilled in the art. Specifically, it is to be understood that the following examples are not intended to limit the scope of the claims to the invention, but are rather intended to be exemplary of certain embodiments. Any variations in the exemplified methods that occur to the skilled artisan are intended to fall within the scope of the present invention. As will be understood by one skilled in the art, there are several embodiments and elements for each aspect of the claimed invention, and all combinations of different elements are hereby anticipated, so the specific combinations exemplified herein are not to be construed as limitations in the scope of the invention as claimed. If specific elements are removed or added to the group of elements available in a combination, then the group of elements is to be construed as having incorporated such a change.

EXAMPLES Example I Study of Activity of VKOR Proteins from Nonhuman Species

This invention applies to additional ways to produce vitamin K dependent proteins (e.g., carboxylated vitamin K dependent proteins). Thus, one aspect of this invention is directed to the discovery that recombinant vitamin K epoxide reductase (VKOR) from highly divergent species can be used to produce vitamin K dependent proteins and to increase carboxylation of vitamin K dependent proteins and in some embodiments such VKOR protein from said highly divergent species is more efficient than its human counterpart in carboxylating a vitamin K dependent protein in cells. The system described herein provides for the measurement of the amount of carboxylation of a reporter protein in a cell based system and the reporter protein in the studies described herein is a chimeric protein C with its Gla domain replaced by that of human factor IX. The amino acid sequence of this chimera is: MAWQLTSLLLFVATWGISGTPAPLDSVFSSSERAHQVLRIRKRYNSGKLEEFVQGNL ERECMEEKCSFEEAREVFENTERTTEFWKQYVDGDQCLVLPLEHPCASLCCGHGTCI DGIGSFSCDCRSGWEGRFCQREVSFLNCSLDNGGCTHYCLEEVGWRRCSCAPGYKL GDDLLQCHPAVKFPCGRPWKRMEKKRSHLKRDTEDQEDQVDPRLIDGKMTRRGDS PWQVVLLDSKKKLACGAVLIHPSWVLTAAHCMDESKKLLVRLGEYDLRRWEKWE LDLDIKEVFVHPNYSKSTTDNDIALLHLAQPATLSQTIVPICLPDSGLAERELNQAGQE TLVTGWGYHSSREKEAKRNRTFVLNFIKIPVVPHNECSEVMSNMVSENMLCAGILG DRQDACEGDSGGPMVASFHGTWFLVGLVSWGEGCGLLHNYGVYTKVSRYLDWIH GHIRDKEAPQKSWAP (SEQ ID NO:_) In the studies described herein, the nucleotide sequence encoding this chimera is expressed in HEK293 cells and the degree of carboxylation is determined by the amount of carboxylated reporter secreted into the medium; this is measured by ELISA using a monoclonal antibody specific for the carboxylated form of the Gla domain of factor IX. FIG. 9 shows that recombinant VKOR from Nematostella is consistently better at promoting carboxylation of the reporter protein in the human cell line than is the over-expressed recombinant human VKOR. This has been repeatedly demonstrated in more than ten experiments. The Nematostella amino acid sequence is only 47.6% identical to the amino acid sequence of human VKOR (FIG. 8 and Table 1), extending the range of functional VKOR sequences considerably.

The nucleotide sequence encoding hamster VKOR (SEQ ID NO:X) that was used in the studies described herein was identified from the Syrian golden hamster cell line MCB3901 [AV12-664], ATTC Accession No. CRL-9595™ (referred to herein as “AV12”). The translated protein sequence is approximately 80% identical to humans VKOR (FIG. 8 and Table 1) and this recombinant hamster VKOR has an undiminished ability, compared to recombinant human VKOR, to promote carboxylation of the reporter protein. Further, recombinant VKOR from a different Cnidarian, Acropora, also promotes carboxylation of the reporter protein in human cell lines (FIG. 9). Although Nematostella and Acropora are from the same phyla, their VKOR sequences are only 54% identical to one another (FIG. 8; see also FIG. 34 for additional VKOR sequence alignments).

For all of the VKOR molecules from the different species described herein, the sequences were synthesized by BlueHeron. The vector used was pIRESpuro 3 from clonetech catalog #631619 (Blue Heron Biotechnology, Bothell, Wash.).

All of the VKOR sequences were made warfarin resistant by substituting the tyrosine at amino acid 139 in the human VKOR sequence with phenylalanine (Y139F). In the nonhuman species, warfarin resistance was established by substituting out the respective tyrosine homologous to human 139 with phenylalanine. These include Y139 in hamster, Y135 in Nematostella, in Y136 in Acropora, Y138 in Xenopus, Y138 in Tokifugu, Y133 in Drosophila, Y144 in Amphioxus, and Y135 in Ciona. VKOR from Mycobacterium tuberculosis was resistant to warfarin at the doses employed in these studies, so the amino acid sequence of this VKOR was not modified for warfarin resistance.

In these experiments all of these species had activities that were at least as high as those of the human VKOR sequence and in some cases higher in the in vivo system used. Many of them have sequences that are only about 50% identical and even as low as 19% identical (e.g., M. tuberculosis) to human VKOR. The experiments have been repeated a number of times.

By every test so far, the VKOR from Nematostella (47.1% identical to human VKOR) is considerably more active than human VKOR itself. In these studies, warfarin is used to eliminate endogenous enzymes in the cell line that is expressing the reporter protein. This means that all of the VKOR variants are rendered warfarin resistant by mutating tyrosine 139 in human VKOR (or its homologue in nonhuman species) to phenylalanine, Y139F. The residue number is slightly different in many species but the homologous tyrosine is modified—unless the tyrosine is naturally not present. The Y139F mutation causes an approximately 50% reduction in the activity of the human VKOR.

These experiments show that VKOR from these organisms can function in mammalian cells to augment carboxylation of vitamin K-dependent proteins. This study demonstrates that VKOR enzymes from a wide variety of organisms are capable of augmenting carboxylation of vitamin K-dependent proteins in cell culture. In addition to the Nematostella results, many other distantly related organisms can also function to promote carboxylation (see, e.g., FIG. 9, FIGS. 27A-B and Table 1) and have the ability to catalyze carboxylation in a cell based system.

In FIG. 10, the availability of different species to catalyze carboxylation of the reporter protein is shown. In this case it is clear that Nematostella VKOR (Nematostella Y135F) has greater ability to stimulate carboxylation than does the human warfarin resistant control VKOR (Y139F). Surprisingly, Mycobacterium tuberculosis VKOR (19.1% identical to human) (MTVKOR) also has greater activity than does the human enzyme. Finally, for this figure, the mutation C51A (C51A/Y139F) in human VKOR also has greater activity than does its control. Synechococcus VKOR (Syn.VKHu) exhibited no activity in this reporter system. Synechococcus in its native form was fused with a thioredoxin type enzyme (Syn.VKTrxHu) and when this coding region is removed, there is again no carboxylation of the reporter protein.

A part of human VKOR was also replaced with sequences from a homologous region of the Mycobacterium tuberculosis gene. Specifically amino acid residues 123 to 139 of human VKOR were replaced with amino acid residues 120-146 of M. tuberculosis (hVKOR M. tuberculosis) and also with residues from other proteins with similar CXXC motifs (Arabidopsis (hVKOR Arabidopsis), Synechococcus (hVKOR Synechococcus), Roseiflexus (hVKOR Roseiflexus) and DsbB protein (hVKOR DsbB); Table 2). Of these, the only molecule with the ability to utilize vitamin K epoxide to carboxylate the reporter protein is Mycobacterium tuberculosis (MT) (FIG. 11A). FIG. 11B shows that human VKORs containing the described substitutions from Arabidopsis (hVKOR Arabidopsis), M. tuberculosis (hVKOR M. tuberculosis), and even the corresponding region from the bacterial enzyme DsbB (hVKOR DsbB), can utilize vitamin K to produce carboxylated reporter protein. In FIG. 11C, KO is used as a substrate in HEK293 cells and the only VKOR with activity is from M. tuberculosis. These studies demonstrate that only the human VKOR substituted with the M. tuberculosis domain functions as a VKOR.

FIG. 12 shows that an increase in the activity of human VKOR results from substituting PY (the sequence in Mycobacterium tuberculosis) for the sequence IV between the active site cysteines 132 and 135 of human VKOR. As noted above, this assay requires the use of warfarin to inhibit endogenous VKOR activity. Therefore, all molecules that were tested have the mutation (at the position homologous to human VKOR Y139F). However it is to be understood that this invention contemplates a VKOR (e.g., human VKOR) with or without a warfarin resistance mutation. This causes a reduction of the activity of human VKOR of approximately 50%. At the level of warfarin used in these assays, the Mycobacterium tuberculosis VKOR is naturally resistant to warfarin.

Human VKOR Y139F is shown in the left most column in FIG. 12. The molecule was rendered warfarin resistant by mutating tyrosine 139 to phenylalanine. In the next column, tyrosine 139 was mutated to another aromatic residue, tryptophan (Y139W). This mutation causes a further reduction in the ability of VKOR to convert VKO to VK. The third column from the left shows human VKOR_(Y139F) with the two residues between the active site cysteines mutated from IV to PY (IV133PY). This substitution almost doubles the ability of human VKOR to promote carboxylation of vitamin K-dependent proteins in the mammalian cell system. The fourth column from left shows that changing residue 139 to W and IV at residues 133 and 134 to PY simultaneously (Y139W_IV133PY) does not restore activity to the Y139W VKOR molecule. The fifth column from the left shows that a VKOR molecule with residues 123 to 139 of human VKOR replaced with residues 120-146 of M. tuberculosis (VKOR-MT-W139F) but with the tryptophan homologous to Y139 mutated to phenylalanine has strong activity. The column on the right shows that human VKOR with its residues 123-139 replaced by the homologous region from M. tuberculosis (VKOR-MT-PY1331V) loses activity when the residues between the active site cysteines (PY) are replaced by the human sequences (IV).

The vector that was used in these experiments was pIRES2 from Clontech but it was modified by removing the DSRed-Express gene and replacing it with the Metridium luciferase gene. The result is a vector that expresses two genes from one transcript.

These data show that bacterial VKOR of Mycobacterium tuberculosis, Nematostella VKOR and the C51A mutation of human VKOR have VKOR activity. In the case of all the metazoans, the relevant conserved tyrosine residue has been converted to phenylalanine to render it warfarin resistant. In the case of the cysteine 51 mutant (C51A), it as well as the wild-type molecule both have this mutation at residue 139. The Mycobacterium tuberculosis VKOR used is naturally resistant to warfarin (in the microgram per ml range). About 50% of the wild-type VKOR activity is observed, so that when human VKOR is compared to Mycobacterium VKOR, although the latter has 2 fold greater activity than human VKOR, the human VKOR is about half its normal activity so they are actually probably about the same activity. For the C51A mutation, the activity is about 2 fold greater than WT VKOR and both have the Y139F mutation.

SEQUENCES

Rat (AAR82917) MGTTWRSPGRLRLALCLAGLALSLYALHVKAARARNEDYRALCDVGTAIS CSRVFSSRWGRGFGLVEHVLGADSILNQSNSIFGCMFYTIQLLLGCLRGR WASILLILSSLVSVAGSLYLAWILFFVLYDFCIVCITTYAINAGLMLLSF QKVPEHKVKKP Mouse (NP_848715) MGTTWRSPGLVRLALCLAGLALSLYALHVKAARARDENYRALCDVGTAIS CSRVFSSRWGRGFGLVEHMLGADSVLNQSNSIFGCLFYTLQLLLGCLRGR WASILLVLSSLVSVAGSVYLAWILFFVLYDFCIVCITTYAINVGLMLLSF QKVPEHKTKKH Hamster used in alignment of FIG. 8 MGTTWRSPGRWRLALCLAGLALSLYALHVKAARARDEDYRALCDVGSAIS CSRVFSSRWGKGLGLVEHVLGPDSVLNQNSIFGCIFYTIQLLLGCLRGRW AFLLLVLSSLVSFAGSVYLAWILFFVLYDFCIVCITTYVIN Cricetulus griseus (Chinese hamster) (XP_003511033.1) MGTTWRSPGR RRLALCLAGL ALSLYALHVK AARARDEDYR  ALCDVGTAIS CSRVFSSRWG KGFGLVEHVL GSDSVLNQSN  SIFGCIFYTI QLLLGCLRGR WASLLLVLSS LVSFAGSVYL AWILFFVLYD FCIVCITTYA INVGLMLLNF QEVPEHKAKR P Human (AAS01052) MGSTWGSPGW VRLALCLTGL VLSLYALHVK AARARDRDYR ALCDVGTAIS CSRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AWILFFVLYD FCIVCITTYA INVSLMWLSF RKVQEPQGKA  KRH Danio rerio (zebrafish) XP_001336460) MSSHSASGVPKWEFRVRLILCILGLVLSVYALHVELSRENNPEYRAMCDL GNSVSCSKVFTSRWGRGFGLVQIFTSKDSVLNQPNSVLGIIFYTLQLGLG QTVSSRAGFFLVMSSWVSVAGSVYLASILAFVLGDFCVVCVSTYIINFAL LYTNLKRRTGLEARLKKGKSQ Takifugu (NP_001027838) MAIPTWERKVRIFLCVFGLLLSVYALHVELSRERNPDYRAMCDLGESVSC SKVFSSRWGRGFGLVQYFVDKDSPLNQPNSVLGIIFYTLQMCLGLSLSRK AALFLVFSSWVSVAGSLYLASILAFVLGDFCMVCVSTYLVNFVLLFTNLK RRRAIEGLKEKSG Xenopus (NP_001006928; NM_001006927) MAVPGWERAVRLLLCGVGIALSVYAYHVETSRERDANYTALCDINPSISC SKVFTSRWGRGFGLVEQILGRQSFLNQPNSVFGILFYGLQVLLGFSGSVG AAAALLGTSLVSIAGSLYLAYILFYVLEDFCVICVTTYALNFCLLLLNLK RLASLRAPPKKQKNKRKKN Acropora (translation of EZ012735) MVSFLGISRLLVCLAGIALSIYALHVELSKAHDKDYKALCDINEHMSCSK VFTSKYGTGFGLVEPLLGKNHPFNVPNSIFGIIFYSLIIILGVVSGKFAA LMMFLFSLASCVGSVYLGYILFYILHDTCVVCISTYVVNACLFVINMITL NDALSAPSPKKKKN Nematostella (XP_001627634) MDKLGGFRMMLCVAGVFLSAYALNVEVSKSNNKDYRAICDISEKISCSKV FSSKYGTGFGLVEPIFGKDSTLNVPNSIFGIMFYTMVFLLGFSRSKLAAQ LSVFSAVLSCLGSVYLGCILYFVLQDVCIICISTYVVNACLLVVNSLSLV NLQERTKRKQK Amphioxus used in alignment in FIG. 8 (two bolded amino acids are different than GenBank ® Database sequence shown below) MAAGRSFRLPIWEILSRCMLCTAGLVLSGYAFYVETSKEADHSYTAMCDV SESVSCSKVFTSRFGRGFGLVEPILGADSPLNLPNSIFGLAFYIMQLCLG VVPGMSVSIVLLATSVLSCLGCVYLAYILYFILQDACIVCISTYVVNTFM LIVNIKRVLLQRKAILKKQQ Amphioxus (XP_002611889; XM_002611843) MAAGRSFRLPIWEILSRCMLCTAGLVLSGYAFYVETSKEADHSYTAMCDV SESVSCSKVFTSRFGRGFGLVEPILGADSPLNLPNSIFGLAFYIMQLCLG VVPGMSVSIVLLATSVLSCLGCVYLAYILYFILQDACIVCISTYVVNTLM LVVNIKRVLLQRKALLKKQQ Ciona (NP_001073142) MNKLLAFRILVCVIGIILSIYAYYVEVAKTNDLSYEALCDFNDVVSCSAV FSSRYGKGLLEYLVGENHFLNQPNSLFGIGFFSIQMLGISPMNKTFNYVL YILTGGGIVTSIYLACILIFVLKDFCVLCVSTYVLTIILHYLNYKLLHHN VNSHKKIN Anopheles (XP_310541) MSILAGNCKCTYTLALVGLSVCGFLLSLYTSYVELRAEHDHTYQAMCDIS ERISCTKVFTSRYGRGFGIVGPLLGDDSLLNVPNGFYGIFYYFLVAGLSF SNNLAVSRLTSYLILLSNGLSLYLAYLLYFVLQDMCVVCVTTYAVNLVSL ILALQKIQALIREEQVMRALKVGKAK Trichoplax (XM_002107720.1) MSLVGLALSVYALHVETTKESNKNYKAFCDFGASISCSKVFTSKYGKGFG LIAPIFGQHSSLNQPNSIYGIIFYCIQICLAFHHTLKITRIVLAMSLLSC IGSFYLAFVLTFVLHDFCLVCVSTYIVNAVVSFLNFKRM Platypus (XM_001515406.1) MGAWVPTRSARVVGPRALGSRVATAVQPSAVDPDTRHDRIPSLRWGRGFG LVEMVLGPDSSLNQPNSVFGLLFYSLQLLLGCSRAPWTSVVLALSSLLSL AGSLYLAWILFFVLHDFCFVCITTYAINVGLALLNYRRLKQAQGKVMKYC DESSPASSLLERRFYSGGGLRNGGSAASFPFPPATGH Drosophila (NP_001014533) MEQAYSTASRLRGICVCGLAISVYSLYVKMKLKEDENYRPMCDVNDNISC SLVFKSGYGDGFGLGNITQVNAPNGAIGCAFYILYFLSSFFNHRWLCLVQ LIVCTLTLLLCVYLGFLLILVFYDFCLVCVTIYFIHTWLFQEVLRRYRRL YM Mycobacterium tuberculosis (NP_217484.1) MVAARPAERSGDPAAVRVPVPSAWWVLIGGVIGLFASMTLTVEKVRILLD PIYVPSCNVNPIVSCGSVMTTPQASLLGFPNPLLGIAGFTVVVVTGVLAV AKVPLPRWYWIGLAVGILVGVAFVHWLIFQSLYRIGALCPYCMVVWAVIA TLLVVVASIVFGPMRENRGSQERVGARLLYQWRWSLATLWFTTVFLLIMV RFWDYSTLI Arabidopsis thaliana (NP_567988.1) MMARFVSVSS CQFHFGFREV SPPSVTSYPR RFEVSDRRFP AIPIKCSSSE PENGEDSAPS LSSSSSSSTS EVSTSNSSTY NWYTGIGGIG MLDTAYLTYL KVTGSDAFCP IGGGTCGDVL NSDYAVVFGV PLPVIGFVMY GVVTALSAEL GEGNLPFGIS KSNGRFALFG ITTAMASASA YFLYILSTKL SGSSCLYCLV SAFLSFSLFF LSVKDVKLQE IQQVVGLQIC LAIIVVASLT ASYSTAQPIP SRSGDIELPY FRTEISSSSS PYAIALAKHL NSIGAKMYGA FWCSHCLEQK EMFGREAAKE LNYVECFPDG YKKGTKILKA CADAAIEGFP TWIINDKVLS GEIELAELAE MTGFSLDQAN ETNQLQ Roseiflexus sp. RS-1 (YP_001274867.1) MRRFLLTLIV SCMLTLSLSV ASAAATVRAV LFYSPRCGHC HMVISEHLPP LQQRYGDQLQ ILMIDVDQAQ GAALYREAIA VYAIPEARRG VPTMIISDTV LVGSVEIPQR LPGLIETLLA RGGSDWPPIP GLADLLATVP TSAPAPPTLP PATAETPPFL RDLPANALAV VVLAGMLLTV MWAGITWSRP AQPPTRWRDR SIPLLAIGGM AVAAYLTFIE TTGAPALCGP VGDCNAVQQS EFARLFGTIP VGAAGVAGYG AILIVWIVAH LLPGTSGERA ALLLPALALI GTLFSIYLTF LEPFVIGATC LWCLTSAVIM TGLLWLSMPY RQRSTSRGYA RR Synechococcus sp. JA-2-3B′a(2-13) (YP_478481.1) MASYLKLKAQ EETWLQRHSR LILAILAGLG SLLTAYLTYT KLTEQPAAFC TGDGGCDLVL SSRWAEFLGI PTAAVGLLGF LGVLALAVLP DGLPLVKRWR WPALFGLVSA MTAFEMYMLY LMVAVLRQFC MYCTTAIILV AGLGLVTVLG HRWLDGGKLA FSYILVAFLT LVTTIGVYAN QVPPPSPLAV GLAAHLRQIG GTMYGAYWCP HCQDQKELFG AAFDQVPYVE CSPNGPGTPQ AQECTEAGIT SYPTWIINGR TYTGVRSLEA LAVASGYPLE EGR Shigella dysenteriae 1012 DsbB protein (ZP_03067529.1) MIMLRFLNQC SQGRGAWLLM AFTALALELT ALWFQHVMLL KPCVLCIYER CALFGVLGAA LIGAIAPKTP LRYVAMVIWL YSAFRGVQLT YEHTMLQLYP SPFATCDFMV RFPEWLPLDK WVPQVFVASG DCAERQWDFL GLEMPQWLLG IFIAYLIVAV LVVISQPFKA KKRDLFGR Corynebacterium jeikeium K411 (YP_250248.1) MWVWWGREGV SNKESEHMNG LGATKRFGYT FLVLSTIGLI FSALIMHDKV QMALDPNFEP ACTFNEVISC TDVMASDQAA TFGFANPFIG MIGFPVMMTL AVMLIVGAKL PRWIWYCALA GLAFGVAFVH WLAYSAIYSI GALCPYCMAV WAATLPMFVM TLVHIQREKR REAGEDVAHS ALGMPLVVII AWFLAFTALI LDQFVF Salinispora tropica CNB-440 (YP_001157037.1) MTTTANRPVT TPAERHFLAA VTAWVLTIGG AVGLLAAAAL TVEKINLLAD PGYVPTCSIN PILSCGSVMN TPQAAVFGFP NPLLGIAGFA VVTTLGVTLL ATGHLPRWMW LGLQGGVTFG VVFVHWLIYQ SLYVIGALCP YCMVVWAVTI PIFLYTTLQT LRDNTTALPR ALRRVTERVA RYHSLVLVVW AAFVVVVILH RFWDYWSTLG Human VKOR with V45N mutation: MGSTWGSPGW VRLALCLTGL VLSLYALHVK AARARDRDYR ALCDNGTAIS ASRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AWILFFVLYD FCIVCITTYA INVSLMWLSF RKVQEPQGKA KRH Human VKOR with C51A mutation: MGSTWGSPGW VRLALCLTGL VLSLYALHVK AARARDRDYR ALCDVGTAIS ASRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AWILFFVLYD FCIVCITTYA INVSLMWLSF RKVQEPQGKA KRH Human VKOR with IV133-134PY mutation: MGSTWGSPGW VRLALCLTGL VLSLYALHVK AARARDRDYR ALCDVGTAIS CSRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AWILFFVLYD FCPYCITTYA INVSLMWLSF RKVQEPQGKA KRH Human VKOR with IV133-134PY mutation and C51A mutation: MGSTWGSPGW VRLALCLTGL VLSLYALHVK AARARDRDYR ALCDVGTAIS ASRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AWILFFVLYD FCPYCITTYA INVSLMWLSF RKVQEPQGKA KRH Human VKOR with amino acids 122-139 substituted with amino acids 129-146 of M. tuberculosis VKOR  (GenBank ® Database Accession No. NP_217484): MGSTWGSPGW VRLALCLTGL VLSLYALHVK AARARDRDYR ALCDVGTAIS CSRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AFQSLYRIGALCPYCMVVWA INVSLMWLSF RKVQEPQGKA KRH Human VKOR with amino acids 122-139 substituted with amino acids 185-202 of Arabidopsis VKOR (GenBank ® Accession No. NP_567988): MGSTWGSPGW VRLALCLTGL VLSLYALHVK AARARDRDYR ALCDVGTAIS CSRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AILSTKLSGSSCLYCLVSAA INVSLMWLSF RKVQEPQGKA KRH Human VKOR with amino acids 122-139 substituted with amino acids 120-137 of Synechococcus VKOR (GenBank ® Accession No. YP_478481): MGSTWGSPGW VRLALCLTGL VLSLYALHVK AARARDRDYR ALCDVGTAIS CSRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AYLMVAVLRQFCMYCTTAIA INVSLMWLSF RKVQEPQGKA KRH Human VKOR with amino acids 122-139 substituted with amino acids 33-50 of DsbB enzyme (GenBank ® Accession No. ZP_03067529): MGSTWGSPGW VRLALCLTGL VLSLYALHVK AARARDRDYR ALCDVGTAIS CSRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AWFQHVMLLKPCVLCIYERA INVSLMWLSF RKVQEPQGKA KRH Human VKOR with amino acids 122-139 substituted with amino acids 300-317 of Roseiflexus VKOR (GenBank ® Accession No. YP_001274867) MGSTWGSPGW VRLALCLTGL VLSLYALHVK AARARDRDYR ALCDVGTAIS CSRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AFLEPFVIGATCLWCLTSAA INVSLMWLSF RKVQEPQGKA KRH Human VKOR with amino acids 44-50  substituted with amino acids DYKDDDDK (Flag tag): MGSTWGSPGW VRLALCLTGL VLSLYALHVK AARARDRDYR ALCDYKDDDDK CSRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AWILFFVLYD FCIVCITTYA INVSLMWLSF RKVQEPQGKA KRH Human VKOR comprising an R37G mutation, an R35G mutation, an R33G mutation, a K30L mutation, a G9R mutation, an S7R mutation and a G6R mutation: MGSTWRRPRW VRLALCLTGL VLSLYALHVL AAGAGDGDYR ALCDVGTAIS CSRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AWILFFVLYD FCIVCITTYA INVSLMWLSF RKVQEPQGKA KRH Human VKOR comprising an R37 mutation (X₁), an R35 mutation (X₂), an R33 mutation (X₃), a K30 mutation (X₄), a G9 mutation (X₅), an S7 mutation (X₆) and a G6 mutation (X₇): MGSTWX ₇ X ₆PX ₅W VRLALCLTGL VLSLYALHVX ₄ AAX ₃AX ₂DX ₁DYR ALCDVGTAIS CSRVFSSRWG RGFGLVEHVL GQDSILNQSN SIFGCIFYTL QLLLGCLRTR WASVLMLLSS LVSLAGSVYL AWILFFVLYD FCIVCITTYA INVSLMWLSF RKVQEPQGKA KRH, wherein: X₁ may be G, A, I, L, V, M, F, W or P; X₂ may be G, A, I, L, V, M, F, W or P; X₃ may be G, A, I, L, V, M, F, W or P; X₄ may be L, I, V, A, G, M, F, W or P; X₅ may be R, H, K, S, T, C, Y, N or Q; X₆ may be R, H, K, T, C, Y, N or Q; and X₇ may be R, H, K, S, T, C, Y, N or Q

Example II Studies of Cysteines

Vitamin K hydroquinone (VKH2) is required as a co-factor for the enzyme gamma glutamyl carboxylase, GGCX. GGCX catalyzes the addition of CO₂ to the gamma carbon of certain glutamic acids of the vitamin K-dependent proteins. For every Glu modification, VKH2 is converted to vitamin K epoxide (VKO) which must be sequentially converted back to vitamin K (VK) and VKH2 for carboxylation to continue. Vitamin K oxidoreductase (VKOR), a member of the thioredoxin protein family is a 163 amino acid, multi-pass, transmembrane enzyme that converts VKO to VK and can also convert VK to VKH2—although a second enzyme may be a major player in the VK to VKH2 reaction as described herein.

Traditionally, the vitamin K-dependent (VKD) proteins were thought to function mainly in blood coagulation; however, VKD proteins that, e.g., prevent calcification of soft tissues and arteries and that regulate cell growth and inflammation are now known.

VKOR is highly conserved throughout the metazoa and there are apparent bacterial homologs. The most obvious similarity between the metazoan VKORs and the bacterial homologs is that there are two pairs of cysteine residues (numbers 43/51 and 131/135 in human VKOR) that are highly conserved among prokaryotes and eukaryotes. The lone exception is the reported sequence of VKOR of the duck-billed platypus which lacks the cysteines corresponding to 43 and 51 in the human numbering system. The platypus VKOR is inactive in the cell based system described herein for analyzing carboxylation in-vivo.

The bacterial VKOR homologs are particularly interesting because of their relationship to the disulfide bond forming enzymes (Dsb) of E. coli. In E. coli, DsbA is a soluble enzyme localized to the periplasm and its main function is to oxidize thiols to disulfides in secreted proteins; its metazoan counterpart is the protein disulfide isomerase family. When DsbA catalyzes disulfide formation in proteins in the periplasm, it active site cysteines are reduced. Since the active form is the disulfide, it must be reoxidized to its active disulfide form by DsbB, a four TM integral membrane protein. Interestingly, many bacterial VKOR homologs can complement E. coli DsbB.

DsbB of E. coli utilizes two pairs of cysteines in its reaction mechanism. In DsbB, it is clear that the cysteines homologous to 43 and 51 of human VKOR accept electrons from reduced proteins in the periplasm becoming reduced to free thiols in the process. These electrons are then shuttled to the active site cysteines, equivalent to cysteines 132 and 135 of human VKOR. These reduced cysteines are then reoxidized by transferring their electrons to ubiquinone. It has been proposed that in human VKOR, cysteine residues 43 and 51 also function to shuttle electrons to the active site cysteines 132 and 135. Because of the conservation of two pairs of cysteines in all of the VKOR molecules, studies were conducted to determine whether, as in bacteria, both pairs of cysteines are required for the in vivo reaction of metazoan VKOR.

Recombinant cysteine mutants of human VKOR have been studied and it has been observed that in vitro, only two cysteines, 132 and 135, are required for its activity. However, because these assay systems used dithiothreitol to reduce VKOR after each reaction cycle, it is possible that these in vitro results do not extend to the in vivo reaction.

Therefore, an assay has been devised to analyze the in vivo function of these cysteine mutant VKORs. This assay is based on quantitation of a carboxylated reporter protein containing the Gla domain of human factor IX expressed in HEK 293 cells, as described herein. Carboxylation of the reporter protein by endogenous VKOR is completely abolished by 4 μM warfarin. However, the ability of the cells to carboxylate the reporter is restored when warfarin resistant recombinant VKOR_(Y139F) is expressed in the presence of 4 μM warfarin. Therefore, all mutant cysteine VKOR molecules were rendered warfarin resistant by introducing the mutation Y139F in addition to the targeted cysteine mutations. The read-out for each mutation is the ability of a HEK293 cell line to produce the carboxylated reporter protein in the presence of 4 μM warfarin.

Because the goal is to determine the relative activity of different mutations, it is necessary to normalize the amount of carboxylated reporter produced in each mutation. However, because most of this work is based upon transient expression of each mutation, correction for transfection efficiency is needed. Transfection efficiency is commonly corrected by co-expressing a marker protein such as luciferase. The amount of carboxylated protein produced, however, is also dependent upon the maximum amount of carboxylated protein the cell is capable of producing; once all of the reporter is carboxylated, no additional signal will be observed. Thus, while the signal from luciferase will continue to increase directly with its increased expression, the reporter signal will be proportional to the amount and specific activity of the introduced VKOR and should saturate. To control for saturation, transfected VKOR_(Y139F) is transfected at different DNA concentrations and the linear range of response is experimentally determined. To control for transfection efficiency, VKOR and luciferase were expressed from either an internal ribosomal entry site vector or from a bi-directional promoter. The ribosomal re-entry vector (pIRES2 DsRed-Express2) uses the internal ribosomal re-entry site of encephalomyocarditis virus. The DS red portion of the vector was replaced with residues of the luciferase from Metridia. In this vector two proteins are made from the same mRNA. In one set of constructs the VKOR molecules were transcribed from the promoter while the luciferase was expressed from the ribosomal re-entry site. The reciprocal constructs were also made and expressed. The same relative results were found with each configuration but there less absolute levels of VKOR were seen when translation originated from the ribosomal re-entry site.

FIG. 13 shows that mutations of active site residues 132 and 135 reduces carboxylation of the reporter protein to background levels. Simultaneous mutation of all 5 non active site cysteines to alanine results in a molecule whose activity is indistinguishable from VKOR_(Y139F), indicating all non active site residues are not essential for the enzyme activity of VKOR. However, mutations of each individual cysteine, indicates otherwise. Mutation of Cys residue 43 results in a molecule with dramatically decreased activity, whether combined with mutations of cysteines 16, 85 and 96 or alone. Simultaneous mutation of residues 43 and 51 restores normal (VKOR_(Y139F)) activity; and, a point mutation of 51 alone in VKOR_(Y139F) results in a molecule with greater activity than VKOR_(Y139F).

Since these results indicate that cysteines 43 and 51 are not, as in bacterial species, shuttle cysteines, bacterial and metazoan VKORs were further analyzed by comparing conserved motifs within VKORs. The hydrophilic loop containing Cys43 and Cys 51 is the most highly conserved motif (FIG. 14; FIGS. 28A-B).

The motif shown in FIG. 14 was derived from the Motif Suite and the training set used included 35 metazoan species ranging from the primitive Nematostella, Acropora and Trichoplax through insects, fish, birds, and several mammals and seven bacterial species. Interestingly, although this motif is the most strongly conserved in metazoans, no bacterial species were found to be included in this motif search. If the number of training sequences is changed so that they are more equally balanced between bacterial and metazoan VKORs seven bacterial species, Corynebacterium urealyticum, Rhodoccus erythropolis, Saccharopolyspora erythraea and M. tuberculosis also contain this motif.

In conclusion, these results suggest that the mechanism of the metazoan VKORs is significantly different from their bacterial homolog because the conserved cysteines at 43 and 51 are not required for in vivo activity while they are required in the bacterial system.

Example III Vitamin K Cycle Study in Mammalian Cells

Vitamin K hydroquinone (KH₂) is a co-factor for γ-glutamyl carboxylase (GGCX), which catalyzes the post-translational carboxylation of specific glutamic acid residues to γ-carboxyglutamic acid (gla) in a variety of vitamin K-dependent proteins¹. Gamma-glutamyl carboxylation is essential for the biological functions of vitamin K-dependent proteins involved in blood coagulation, bone metabolism, signal transduction, and cell proliferation. Concomitant with γ-glutamyl carboxylation, KH₂ is oxidized to vitamin K 2,3-epoxide (KO). KO must then be converted back to vitamin K (the quinone form) and then KH₂ by two separate electron reductions to support the carboxylation reaction. The cyclic production of KO and conversion back to KH₂ constitutes the vitamin K cycle (FIG. 1). The only enzymes unequivocally identified as part of the cycle are GGCX and vitamin K epoxide reductase (VKOR)².

Identification of the gene encoding VKOR^(20,21) has made it possible to study the function of the enzyme at the molecular level. It is now clear that in vitro, VKOR can reduce both KO to vitamin K and vitamin K to KH₂. VKOR catalyzes both reactions using the same cysteine residues (132 and 135) at the active site^(22,23). In addition, both reactions are sensitive to warfarin inhibition²³. It is worth noting that in vitro VKOR converts KO to vitamin K approximately 50 times faster than it converts vitamin K to KH₂ ²³. Both VKOR and GGCX have been purified and characterized, and the enzymes have very different lipid and/or detergent requirements for activity. This makes studying the interactions and activities of the enzymes together in vitro difficult.

In the present work, a cell-based reporter assay system has been developed that enables the functional study of the complete vitamin K cycle. In this system, a vitamin-K dependent reporter protein is expressed that is easily measured and that reflects the efficiency of vitamin K-dependent carboxylation in vivo. Protein C was used as the reporter for this study. For detection purposes, the gla domain of protein C was replaced with that of factor IX (FIX). This replacement allowed the use of a monoclonal antibody specific for the carboxylated gla domain of FIX for quantitative detection purposes^(24,25). This chimeric reporter protein, FIXgla-PC, was stably expressed in HEK293 cells, which are commonly used for the biosynthesis of vitamin K-dependent proteins, and in AV12 cells, which are less efficient in the carboxylation of vitamin K-dependent proteins²⁶. Studies indicate recombinant protein C produced by HEK293 cells is fully carboxylated and even more active than plasma-derived protein C. However, under similar culture conditions, protein C produced by AV12 cells is partially carboxylated with only 20% anticoagulant activity relative to plasma protein C²⁶. This indicates that HEK293 and AV12 cells might have different pathways of using vitamin K for making vitamin K-dependent proteins. A study of the contributions of the various enzymes involved in the two-step reduction of KO was carried out by expressing the reporter protein in these two cells lines, and by feeding the cells KO or vitamin K, with or without warfarin, expressing warfarin-resistant VKOR-Y139F, and using dicoumarol to inhibit NQO1.

Materials. Vitamin K₁, warfarin, dicoumarol, and CHAPS were obtained from Sigma-Aldrich (St. Louis, Mo.). Vitamin K₁ 2,3-epoxide was prepared as described previously²⁷. Vitamin K₁ (10 mg/mL) for cell culture was from Abbott Laboratories (Chicago, Ill.). A vitamin K internal standard for VKOR activity assay, 2-methyl-3(3,7,11,15,19-pentamethyl-2-eicosenyl)-1,4-naphthalenedione (vitamin K₁₍₂₅₎), was from GLsynthesis Inc. (Worcester, Mass.). Protein C cDNA clone was from Open Biosystems (Huntsville, Ala.). Mammalian expression vector pcDNA3.1/hygro(+) and Lipofectamine were from Invitrogen (San Diego, Calif.). Mammalian expression vector pCI-neo was from Promega (Madison, Wis.). HEK293 and AV12 cell lines were from ATCC (Manassas, Va.). Mouse anti-carboxylated FIX gla domain monoclonal antibody (α-FIXgla MAb) was obtained from GlaxoSmithKline (Philadelphia, Pa.) and Green Mountain Antibodies (Burlington, Vt.)²⁸. Affinity purified sheep anti-human Protein C IgG and its horseradish peroxidase conjugate were from Affinity Biologicals Inc. (Ancaster, ON Canada).

Construction of the FIXgla-PC Reporter Fusion Protein.

The gene encoding human protein C was amplified by PCR using pCMV-SPORT6-Protein C as a template. The gla domain of protein C (residue 1 to 46) was exchanged with the gla domain of FIX. This FIXgla-PC fusion was subcloned into the mammalian expression vector pcDNA3.1/hygro (+) using the XbaI site to generate the reporter protein expression vector, pcDNA3.1-FIXgla-PC.

Expression of the FIXgla-PC in HEK293 and AV12 Cells.

The FIXgla-PC reporter protein was stably expressed in HEK293 or AV12 cells. Cells were transfected with pcDNA3.1-FIXgla-PC plasmid DNA using Lipofectamine according to the manufacturer's protocol. After selection with 300 μg/ml hygromycin, surviving colonies were picked and screened for high stable expression. Single colonies were cultured in Dulbecco's Modified Eagle's Medium: Nutrient Mixture F-12 (DMEM/F12) supplemented with 10% fetal bovine serum, 11 μM vitamin K, and 1× antibiotics-antimycotics (complete medium) in a 24-well plate for 48 hours. Cell culture medium was collected and directly used for quantification of the secreted carboxylated FIXgla-PC by ELISA. The colony with the highest FIXgla-PC production was selected as the stable cell line to be used for reporter gene expression.

To purify carboxylated FIXgla-PC fusion proteins for use as a standard for ELISA, α-FIXgla MAb was coupled to Affi-Gel 10 (Bio-Rad Laboratories, Hercules, Calif.) according to the manufacturer's protocol. HEK293 cells stably expressing a high level of FIXgla-PC reporter protein were cultured in complete medium supplemented with 11 μM vitamin K. The medium was collected after a 48-hour incubation. Calcium chloride was added to the collected medium to a final concentration of 5 mM. Five hundred ml of the medium was incubated with 1.5 ml of the prepared anti-carboxylated FIXgla domain affinity beads overnight at 4° C. with gentle stirring. The beads were spun down and packed into a 1.5×10 cm column. The column was washed first with 20 mM Tris-HCl, 500 mM NaCl, and 5 mM CaCl₂ and then with 20 mM Tris-HCl, 100 mM NaCl, and 5 mM CaCl₂. Carboxylated FIXgla-PC reporter protein was eluted with 20 mM Tris-HCl, 100 mM NaCl, and 10 mM EDTA.

To examine the effect of vitamin K, KO, warfarin, or dicoumarol on the carboxylation of the reporter protein, HEK 293 or AV12 cells stably expressing FIXgla-PC were sub-cultured in 24-well plates. When cells were 60-70% confluent, vitamin K, KO, warfarin, or dicoumarol was added to the complete medium and incubated for 48 hours. Cell culture medium was collected and directly used in an ELISA as described in the following section.

FIXgla-PC Measurement in Cell Culture Medium Using ELISA.

The reporter protein in the cell culture medium was quantified by ELISA as described previously with minor modification²⁹. To assay for carboxylated FIXgla-PC, a conformation-specific monoclonal antibody that recognizes only the fully carboxylated FIXgla domain in the presence of calcium was used as the coating antibody²⁸. 96-well ELISA plates were coated overnight at 4° C. with 100 μL/well α-FIXgla MAb. The concentration of the coating antibodies was 2 μg/ml in 50 mM carbonate buffer (pH 9.6). After being washed 5 times with TBS-T wash buffer (20 mM Tris-HCl, pH 7.6, 150 mM NaCl, and 0.1% Tween 20), the plate was blocked with 0.2% BSA in TBS-T wash buffer for 2 hours at room temperature. Samples and protein standards (0.12-250 ng/mL) with 5 mM CaCl₂ were added at 100 μL/well and incubated for 2 hours at room temperature. After being washed with TBS-T wash buffer containing 5 mM CaCl₂, sheep anti-human protein C IgG conjugated to horseradish peroxidase (100 μL/well at 1:2500 in TBS-T wash buffer with 5 mM CaCl₂) was added to each well and incubated for 45 minutes at room temperature. After the unbound detecting antibody was washed off, 100 μL of ABTS solution (Roche Molecular Biochemicals, Indianapolis, Ind.) was added to each well and the absorbance was determined at 405 nm with a THERMOmax microplate reader (Molecular Devices). The linear range for detection of carboxylated FIXgla-PC was between 0.50 ng/ml and 125 ng/ml (γ=0.9987) using the logit (OD)-log (FIXgla-PC) plot.

To assay for total reporter protein secreted into the cell culture medium, 96-well ELISA plates were coated with 100 μL/well mouse anti-human protein C monoclonal antibody overnight at 4° C. After being washed and blocked as described above, samples and protein standards (0.12-250 ng/mL) were added and incubated for 2 hours at room temperature. After the unbound samples were washed off, sheep anti-human protein C IgG was added to each well and incubated for another 2 hours at room temperature. Then unbound antibody was washed off and the plate was incubated with 100 μL/well rabbit anti-sheep IgG conjugated to horseradish peroxidase for 45 minutes at room temperature. Color development was performed as described above.

Functional Study of Warfarin-Resistant VKOR-Y139F in Established Cell Lines

To study the contribution of VKOR to the vitamin K cycle, a warfarin resistant VKOR mutant, VKOR-Y139F, was cloned into the mammalian expression vector pCI-neo. The resulting plasmid was transiently or stably transfected into the established cell line FIXgla-PC/HEK293 or FIXgla-PC/AV12. The culture medium on the cells transiently expressing VKOR was changed 30 hours post-transfection to complete medium containing 5 μM KO or 5 μM KO with 2 μM warfarin. Cell culture medium was collected after a 48-hour incubation and directly used for ELISA. The stably transfected colony that expressed the highest level of VKOR-Y139F was selected for further study. The effect of over-expressing the VKOR-Y139F mutant on reporter protein carboxylation under different conditions was tested as described herein.

GGCX Activity Assay. GGCX activity was determined by the incorporation of ¹⁴CO₂ into the pentapeptide substrate, FLEEL, in the presence of propeptide³⁰. 1×10⁶ of HEK293 or AV12 cell pellets were mixed with 115 μL of ice cold lysis buffer containing 0.5% CHAPS, 25 mM Tris-HCl (pH 7.5), 500 mM NaCl, 4 μM factor IX propeptide, 1.25 mM FLEEL and 1× protease inhibitor cocktail. Samples were placed on ice for 30 minutes with occasional vortexing. The carboxylation reaction was started by the addition of 10 μL of an ice-cold mix of NaH¹⁴CO₃ (40 μCi/mL) and KH₂ (222 μM) to bring the volume to 125 μL. The reaction mix was immediately transferred to a 20° C. water bath and incubated for 45 minutes. The amount of ¹⁴CO₂ incorporation was determined as described previously³¹.

VKOR Activity Assay.

VKOR activity was determined as previously described with minor modification^(21,32). HEK293 or AV12 cells (1×10⁷) were collected and re-suspended in 200 μL of ice cold assay buffer containing 25 mM TAPS (pH 8.6), 150 mM NaCl, 30% glycerol, 50 μM KO and 1× protease inhibitor cocktail. Cells were lysed by sonication on ice. The reaction was started by adding 5 mM (final concentration) freshly prepared dithiothreitol (DTT) and incubated at 30° C. in the dark for 45 minutes. The reaction was terminated by the addition of 500 μL isopropanol. The reaction mixture was extracted with 500 μL n-hexane containing 2.52 μM vitamin K₁₍₂₅₎ as an internal standard. The upper organic phase containing the vitamins was transferred to a 2-ml brown vial and dried with nitrogen. A total of 500 μL of HPLC mobile phase was added to dissolve the vitamins and the sample was analyzed by HPLC³².

FIXgla-PC Chimera as a Reporter Protein for Vitamin K-Dependent Carboxylation Efficiency in Living Cells.

To study the vitamin K cycle in vivo, the chimeric reporter protein described above was expressed as a tool for determining the efficiency of in vivo vitamin K-dependent carboxylation. In the presence of vitamin K or KO, secretion of carboxylated reporter protein increased approximately 25-fold (FIG. 2) compared to no additions. Warfarin, an inhibitor of VKOR, eliminated KO-supported carboxylation. In addition, similar levels of carboxylated reporter were secreted independent of the substrate (vitamin K or KO) fed to the cells. As described below, this allowed for the differentiation of some of the functions of the various enzymes involved in the cycle.

Effect of Substrate and/or Warfarin on FIXgla-PC Carboxylation in HEK293 Cells.

With KO as substrate, FIXgla-PC carboxylation was completely inhibited by 2 μM warfarin, and 50% inhibition occurred with 0.1 μM warfarin (FIG. 3A). Thus, VKOR, the molecular target for warfarin, is responsible for the reduction of KO in vivo. While warfarin totally inhibited FIXgla-PC carboxylation when HEK293 cells were fed KO, HEK293 cells fed vitamin K produced high (unaffected) levels of carboxylated protein in the presence of warfarin (FIG. 3A). This result suggests that as long as there is enough vitamin K in the medium, inactivation of VKOR by warfarin does not affect the conversion of vitamin K to KH₂ by the vitamin K-dependent carboxylation in HEK293 cells. This was confirmed by the result in FIG. 3B, which shows the amount of the carboxylated FIXgla-PC secreted as a function of vitamin K concentration in the presence and absence of warfarin. In the absence of warfarin, carboxylation occurred maximally at 1 μM vitamin K. However, in the presence of warfarin, less than 20% of the carboxylated reporter protein was detected in the medium at 1 μM vitamin K, and maximal carboxylation was detected in the medium at 22 μM vitamin K. The decreased carboxylation efficiency observed at lower vitamin K concentrations in the presence of warfarin might have been due to the inability of cells to either recycle KO or to a low affinity/catalytic efficiency of the warfarin-resistant vitamin K reductase in cells. These results suggest that at high vitamin K concentrations, HEK293 cells efficiently support vitamin K-dependent carboxylation, even when VKOR is inactivated by warfarin. Therefore, there must be a warfarin resistant enzyme that reduces vitamin K to KH₂ in HEK293 cells. This enzyme may be the antidotal enzyme that allows patients poisoned with warfarin to be rescued with high doses of vitamin K^(33,34).

Expression of FIXgla-PC in AV12 Cells.

Next, FIXgla-PC was stably expressed in AV12 cells, which carboxylate vitamin K-dependent proteins less efficiently than HEK293 cells²⁶. Under similar conditions, AV12 cells produced only about half as much carboxylated protein as HEK293 cells. The effect of warfarin on FIXgla-PC carboxylation in AV12 cells was then tested using KO or vitamin K as the vitamin K source. When KO was used as substrate, the inhibition curve of warfarin on reporter protein carboxylation (FIG. 4A) was similar to that observed in HEK293 cells (FIG. 3A). In AV12 cells, in contrast to HEK293 cells, production of carboxylated reporter protein was significantly inhibited by warfarin when vitamin K was used as substrate (FIG. 4A). In addition, high concentrations of vitamin K did not rescue warfarin inhibition in AV12 cells (FIG. 4B). These results suggest that warfarin-sensitive VKOR is responsible for KO reduction and that the amount of warfarin resistant antidotal enzyme that reduces vitamin K is dramatically less in AV12 cells than in HEK293 cells.

To understand the reason for the differences in carboxylation efficiency between HEK293 and AV12 cells, the in vitro activity of the endogenous VKOR and GGCX was tested in the two cell types (FIG. 5). It was found that GGCX activity was about 3-fold higher in AV12 cells than in HEK293 cells. However, the in vitro VKOR activity of AV12 cells was approximately 66% of that observed in HEK293 cells. The difference between these two cell lines in endogenous VKOR activity correlates with the observation that AV12 cells produce less carboxylated reporter protein than do HEK293 cells. The endogenous GGCX and VKOR activity results agree with the previous observation³⁵ that the rate of KH₂ production rather than the rate of vitamin K-dependent carboxylation can be the rate-limiting step for in vivo vitamin K-dependent protein carboxylation.

Contribution of NQO1 to Vitamin K Reduction.

Dicoumarol-sensitive NQO1 was originally isolated as a vitamin K reductase³⁶. Subsequently, it was reported that NQO1 can accomplish the two-electron reduction of vitamin K to KH₂ in vitro^(11,37). Therefore, the contribution of NQO1 to the conversion of vitamin K to KH₂ was examined in vivo by adding increasing concentrations of dicoumarol to the cell culture medium with either vitamin K or KO as substrate in HEK293 cells. FIG. 6A shows that, as with warfarin, dicoumarol significantly inhibited reporter protein carboxylation when KO was the vitamin K source. This result demonstrates that dicoumarol is a strong inhibitor for VKOR. However, when cells were fed vitamin K, only minimal inhibition was observed. Results from the in vitro assay show that the inhibition constant of dicoumarol for NQO1 is 0.5 nM, while 1.6 μM is required to reach 50% inhibition of NQO1 from the cell-based assay³⁸. When the cells were treated with 20 μM dicoumarol, a level reported to almost completely inactivate over-expressed NQO1 in intact cells³⁸, 60% of the reporter protein was carboxylated. These results suggest that NQO1 contributes minimally to the reduction of vitamin K to KH₂ in the vitamin K cycle. Therefore, another, still unidentified dicoumarol/warfarin insensitive enzyme must be the major antidotal enzyme that reduces vitamin K in HEK293 cells.

The effect of dicoumarol on reporter protein carboxylation was then tested in AV12 cells. FIG. 6B shows that when KO was the vitamin K source, the inhibition of reporter protein carboxylation by dicoumarol was similar to that in HEK293 cells (FIG. 6A). A significant difference between AV12 cells and HEK293 cells was observed when the cells were grown in the presence of vitamin K; in this case, dicoumarol completely inhibited reporter protein carboxylation in AV12 cells. Moreover, the inhibition curve was similar to that when KO was used as the substrate (FIG. 6B). This result supports the results in FIG. 4A, indicating that unlike HEK293 cells, AV12 cells have very little antidotal enzyme. The ˜20% residual activity observed when vitamin K was used as the substrate (FIG. 4A) may have been due to NQO1 activity, which is inhibited by dicoumarol but not by warfarin. Taken together, these data suggest that NQO1 plays a limited role in converting vitamin K to KH₂ in the vitamin K cycle in vivo.

Contribution of VKOR to the Reduction of Vitamin K to KH₂.

These results confirm that VKOR is responsible for the reduction of KO to vitamin K. To test the ability of VKOR to reduce vitamin K to KH₂ in vivo, tyrosine 139 was mutated to phenylalanine (Y139F), which converts VKOR to a warfarin-resistant form²⁰. This permitted the inactivation of endogenous VKOR by warfarin while testing the in vivo function of the VKOR-Y139F.

VKOR-Y139F was transiently expressed in HEK293 and AV12 cells that stably expressed the FIXgla-PC. Cells transfected and not transfected with VKOR-Y139F were grown in complete medium containing 5 μM KO with 2 μM warfarin. As shown in FIG. 7A, 2 μM warfarin inactivated the endogenous VKOR present in the non-transfected cells of both cell lines. Therefore, almost no carboxylated reporter protein was secreted into the medium (control). In cells transiently expressing VKOR-Y139F, significant amounts of carboxylated reporter protein were produced in HEK293 cells (˜20-fold increase compared to the control) but not in AV12 cells. It was reasoned that this was because the transiently expressed VKOR-Y139F converted KO to vitamin K in the presence of warfarin. In HEK293 cells, the endogenous warfarin resistant antidotal enzyme further reduced vitamin K to KH₂ for the carboxylation reaction. Because there is very little antidotal enzyme present in AV12 cells, warfarin also inactivates the reduction of vitamin K to KH₂ (FIG. 4A). However, if VKOR were the major contributor to the conversion of vitamin K to KH₂, AV12 cells transiently expressing the VKOR-Yl 39F mutant should produce significant amounts of carboxylated reporter protein, as observed in HEK293 cells. Therefore, this result indicates that the contribution of VKOR to the reduction of vitamin K to KH₂ in vivo is small. In addition, these results suggest that in AV12 cells, a warfarin-sensitive enzyme different from VKOR converts vitamin K to KH₂.

An alternative explanation for why no carboxylated reporter protein was secreted from AV12 cells that transiently expressed VKOR-Y139F could be that VKOR-Y139F is not highly expressed in the cells or the expressed protein is unable to convert KO to vitamin K. To clarify this, VKOR-Y139F was stably expressed in AV12 cells. The colony exhibiting the highest level of VKOR-Y139F expression was chosen for further study. As shown in FIG. 7B, over-expression of VKOR-Y139F increased reporter protein carboxylation approximately two-fold when KO was used as the substrate in the culture medium. This suggests that VKOR-Y139F is a functional protein that is able to reduce KO in AV12 cells. Importantly, warfarin also abolished reporter protein carboxylation in this cell line, which stably over expressed VKOR-Y139F. This evidence further implies that VKOR has a limited ability to convert vitamin K to KH₂ in vivo.

The initial goal in this study was to develop an in vivo assay that would allow for the study of the function of enzymes involved in the vitamin K cycle, and to identify other enzymes that are important.

The two reductions in the vitamin K cycle were studied by feeding the cells either KO or vitamin K. Cells cultured in medium containing KO and warfarin produced significantly less carboxylated reporter protein (FIGS. 2-4). Since VKOR is the primary target of warfarin, this indicates that the in vivo reduction of KO is mainly carried out by VKOR. In addition, the fact that when fed vitamin K, even in the presence of warfarin, the cells produce a similar amount of carboxylated protein, shows that there is a so-called antidotal enzyme in the HEK293 cells.

The reduction of vitamin K to KH₂ has been proposed to be carried out by two pathways^(7,40), one accomplished by VKOR, which is sensitive to warfarin inhibition, and the other by NQO1, which is resistant to warfarin inhibition. To clarify the role of NQO1 in the vitamin K cycle, the effect of dicoumarol, an inhibitor of NQO1, was tested on reporter protein carboxylation. When vitamin K was used as the substrate, carboxylation of the reporter protein was decreased by only ˜20%. This result suggests that NQO1 is not the antidotal enzyme

Unlike in HEK293 cells, warfarin inhibits FIXgla-PC carboxylation in AV12 cells when vitamin K is used as the substrate. High concentrations of vitamin K cannot rescue the inhibition. Different cell types have different mechanisms of vitamin K uptake and metabolism which could affect the amount of reporter protein carboxylation^(42,43). However, in HEK293 cells, maximum carboxylation of FIXgla-PC occurs at 1 μM while in AV12 cells it occurs at 2.5 μM (FIGS. 3B and 4B, respectively). Therefore, it is unlikely that these two cell lines have significant differences in vitamin K uptake. Furthermore, a saturated concentration of vitamin K (11 μM) was used in these experiments. This suggests that with vitamin K as substrate, the different warfarin sensitivities of these two cells are likely due to a lack of antidotal enzyme in AV12 cells. This also implies that the majority of vitamin K reduction in AV12 cells is carried out by a warfarin sensitive pathway.

There seems to be little doubt that VKOR can reduce vitamin K to KH₂ ^(2,23). However, this study with purified VKOR indicated that the rate of conversion of vitamin K to KH₂ was considerably slower than the rate of the conversion of KO to vitamin K²³. In the present study, to test the contribution of VKOR to the reduction of vitamin K to KH₂ in vivo, a warfarin resistant VKOR mutant (Y139F) was expressed. When fed KO in the presence of warfarin, HEK293 (Y139F) cells produced carboxylated reporter protein. However, under similar conditions AV12 (Y139F) cells failed to produce significant carboxylated reporter protein. Importantly, VKOR-Y139F is expressed and active in AV12 (Y139F) cells, since the amount of carboxylated reporter protein doubled in the absence of warfarin when these cells were fed KO. Therefore, only the HEK293 (Y139F) cells which have antidotal enzyme can support the complete vitamin K cycle in the presence of warfarin.

Since, in vitro, both KO to vitamin K and vitamin K to KH₂ reactions of VKOR are inhibited by warfarin^(22,23), the most straightforward conclusion from this result is that the in vivo function of VKOR is to convert KO to vitamin K and that a second enzyme is required to convert vitamin K to KH₂.

A second implication of these results is that there must be a warfarin sensitive enzyme, other than VKOR, which converts vitamin K to KH₂ in AV12 cells. The existence of a second warfarin sensitive enzyme is unexpected, because Cooper et al. did a retrospective study utilizing 550,000 SNPs from 181 patients and found only polymorphisms in VKOR and cytochrome P450 2C9 affected warfarin dose requirements. Based on that result they concluded that it was unlikely that another enzyme affecting warfarin sensitivity would be found⁴⁴. On the other hand, at present, polymorphisms in VKOR and cytochrome P450 2C9 combine to account for only 30%-60% of the variance in the stabilized warfarin dose distribution⁴⁵.

The methods described in this work will be important for further studies of the vitamin K cycle. For example, cell utilization of different forms of vitamin K, i.e., menaquinones versus phylloquinones, may account for some of the hepatic and peripheral carboxylation differences in warfarin sensitivity and response to vitamin K as an antidote to warfarin⁴⁶. On the other hand it is possible that the cells that do not respond to vitamin K treatment during warfarin poisoning may have lower levels of the warfarin-resistant vitamin K reductase (antidotal enzyme). Additionally, there are indications that long-term warfarin therapy may cause unwanted effects of bone fracture and vascular calcification. These problems are apparently due to the inhibition of carboxylation of regulator proteins such as matrix gla protein (MGP) and the growth arrest specific gene 6 product (Gas-6)⁴⁷⁻⁵⁰. This cell-based system will be useful in studying these and other questions relating to the vitamin K cycle.

In summary, an in vivo assay system has been established for the functional study of the vitamin K cycle. The two-step reduction of vitamin K can be studied separately using this system by feeding the cells either KO or vitamin K. Evidence is provided in this study of a warfarin sensitive enzyme that converts vitamin K to KH₂ that is different from VKOR and the warfarin resistant antidotal enzyme. This antidotal enzyme for vitamin K reduction is probably not NQO1. Finally, this study shows that the main function of VKOR is to convert KO to vitamin K, not vitamin K to KH₂.

REFERENCES FOR EXAMPLE III

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Example IV Mycobacterium Tuberculosis Vitamin K Epoxide Reductase Homologue Supports Vitamin K-Dependent Carboxylation in Mammalian Cells

Vitamin K epoxide reductase (VKOR) is a critical participant in the production of active forms of reduced vitamin K and is required for modification of vitamin K dependent proteins. Homologues of VKOR (VKORH) exist throughout evolution but in bacteria, they appear to function in oxidative protein folding as well as quinone reduction. In the present study two questions are explored: Do VKORHs function in the vitamin K cycle? Is the pair of loop cysteines, C43 and C51 in human VKOR, highly conserved in all VKORs, essential for the activity of vitamin K epoxide reductase?

A cell-based assay was used to compare the function of VKORHs to that of human VKOR in mammalian cells. What was identified for the first time was a VKORH (from Mycobacterium tuberculosis, MT-VKORH) that can function in the mammalian vitamin K cycle with vitamin K epoxide or vitamin K as substrate. Consistent with previous in vitro results, the loop cysteines of human VKOR are not essential for its activity in vivo. Moreover, the corresponding loop cysteines of MT-VKORH(C57 and C65), which are essential for its activity in disulfide bond formation during protein folding in E. coli, are not required in the mammalian vitamin K cycle.

These results indicate that VKOR in eukaryotes and VKORH in bacteria, i.e., in their native environments, employ fundamentally different mechanisms for electron transfer to the active site during quinone reduction. However, when either is in the mammalian system both VKORH and VKOR employ a similar mechanism.

Vitamin K epoxide reductase (VKOR) is an endoplasmic reticulum (ER) integral membrane protein (19,24). It is responsible for the conversion of vitamin K epoxide (KO) to vitamin K (a quinone), and can also convert vitamin K to vitamin K hydroquinone (KH₂). This series of quinone reductase reactions is an essential part of a redox cycle known as the vitamin K cycle (3). The active form of the vitamin, KH₂, is a cofactor for post-translational modification of proteins essential for blood coagulation, bone homeostasis, signal transduction, and cell proliferation (7,29).

VKOR is a member of a large family of homologues (VKORH) widely distributed among vertebrates, invertebrates, plants, bacteria, and archaea (13). All of these enzymes are quinone reductases, but in bacteria they also participate in disulfide bond formation during protein folding. The significance of VKOR′ s role in the latter process in eukaryotes remains unclear (33). In bacteria, VKORHs are present essentially in strains lacking the quinone reductase (DsB) (8). At least some of these bacterial VKORHs can complement DsbB in E. coli DsbB deletion mutant strains (8,27,35).

DsbB and VKORHs have two pairs of conserved cysteines which are necessary for catalysis (30,36). The active site, CXXC, reduces ubiquinone and a second pair, the loop cysteines, oxidize DsbA to its active form. In DsbB the reduced loop cysteines then shuttle electrons from DsbA to reduce the CXXC to cysteines. In E. coli complementation studies, all four conserved cysteine residues in bacterial VKORH are required for activity (20,35). In vitro studies with Synechococcus VKORH also support this conclusion (20). Based on these results, an intra-molecular electron transfer pathway between the two pairs of conserved cysteines, similar to that of DsbB, has been proposed for the bacterial VKORHs as well as for mammalian VKOR (20,26).

While the electron flow in DsbB is well established, the mechanism for active site regeneration in VKOR is less clear. Experimental data from site-directed mutagenesis confirms that two conserved cysteine residues, C132 and C135, comprise the CXXC redox center in human VKOR (17,23,34). But reports of the function of the other pair of conserved loop cysteine residues, C43 and C51, do not allow a consistent interpretation for their role (17,22,23). It appears that VKOR′ s active site can be reduced in at least two ways. Results from thioredoxin (Trx)/Trx reductase as reductant suggest the loop cysteines are important for activity. On the other hand, with dithiothreitol (DTT) as reductant the loop cysteines do not appear to be essential (17,23,34). This latter observation is also true with the Synechococcus VKORH (20). This would indicate that the active site can be reduced directly by DTT or indirectly by a mechanism involving the loop cysteines.

The present study employs a cell-based assay for studying the vitamin K cycle (31), to examine whether there are any VKORHs that can support vitamin K dependent (VKD) carboxylation in mammalian cells. Second, in vitro studies concerning the roles of the conserved loop cysteines are extended to this in vivo assay to assess the role of these residues in a milieu in which the enzyme would have to interact with its reduction partner and other forms of the VKORH have a similar electron transfer pathway and membrane structure in mammalian cells compared to that in bacteria.

Materials.

Vitamin K₁ and warfarin were obtained from Sigma-Aldrich (St. Louis, Mo.). Luciferase substrate coelenterazine was from Nonalight Technology (Pinetop, Ariz.). Mammalian expression vector pIRES2 DsRed-Express2, secreted Metridia luciferase containing vector pBI-CMV5, and Xfect transfection reagent were from Clontech Laboratories, Inc. (Mountain View, Calif.). The cDNA sequences coding the VKORHs and DsbB used in the study were optimized for mammalian cell expression and chemically synthesized by Blue Heron Biotechnology (Bothell, Wash.). Mouse anti-carboxylated FIX gla domain monoclonal antibody (BC2) was from GlaxoSmithKline (Philadelphia, Pa.) and Green Mountain Antibodies (Burlington, Vt.) (1,10). Horseradish peroxidase conjugated affinity purified sheep anti-human Protein C IgG was from Affinity Biologicals Inc. (Ancaster, ON Canada). Anti-HPC4 monoclonal antibody was from Oklahoma Medical Research Foundation, Oklahoma City, Okla.

DNA Manipulations and Plasmid Constructions.

Mammalian expression vector pIRES2 DsRed-Express2 was used as the basic cloning vector. The red fluorescent protein DsRed-Express2 was replaced by secreted Metridia luciferase which was used as the internal control for normalizing the transient transfection efficiency. The resulting vector pIRES2-Met.Luc was used for expressing all the molecules used in this report. This vector permits both the target protein and the secreted Metridia luciferase to be translated from a single mRNA transcript with a ribosome re-entry site.

All VKORHs and warfarin resistant human VKOR (Y139F) and their mutants were sub-cloned into the EcoRI site of the pIRES2-Met.Luc vector under control of the cytomegalovirus promoter. To create the N-linked glycosylation site in the first periplasmic loop of Mycobacterium tuberculosis (MT) VKORH, residues P61 and 162 were mutated to S61 and T62, respectively. Together with residue N60, this introduces a NST sequence between the pair of cysteine residues C57/C65. Due to the short carboxyl terminus of MT-VKORH and the requirement of at least 12 amino acid residues between the glycosylation site and the membrane interface (21), a N-linked glycosylation consensus sequence (NST) with a flexible extension linker (GGSGGSGGS) was introduced at the carboxyl terminus of MT-VKORH. All the constructs for glycosylation study have a HPC4 tag at their carboxyl terminus for western blot detection.

In Vivo VKOR Activity Assay.

VKOR in vivo activity was determined with a cell-based assay as described previously (31). Luciferase activity was determined by injecting 50 μl of coelenterazine solution (2 μM in PBS with 300 mM NaCl) to 50 μl of cell culture medium directly. Luminescence emission from the mixture was recorded at 480 nm with a delay of 6 seconds and integration time of 1 second. Transfection efficiency was normalized by the expression of Metridia luciferase in cell culture medium. Abilities of enzymes to use vitamin K and KO to support VKD carboxylation were evaluated as described. One way analysis of variance was used to assess significant differences as indicated. The criterion for statistical significance was set as P<0.05 or 0.001.

Western Blot.

To analyze glycosylation modification of the introduced N-linked glycosylation site in MT-VKORH, mutant proteins were transiently expressed in HEK293 cells. Four-eight hours post-transfection, cells were harvested and lysed in 300 μl PBS with 1% Triton X-100 and 1× protease inhibitor cocktail. For deglycosylation, 1 μL PNGase F (500 U/μL) was added to a 50-μL aliquot of the cell lysate and incubated for 30 minutes at 37° C. Deglycosylated and non-treated samples were directly subjected to SDS-NuPAGE under reducing condition. Western blot analysis was performed as described previously (32).

Investigation Of VKORHs' Ability to Support In Vivo VKD Carboxylation with KO as Substrate.

Some VKORHs have certain structural and functional characteristics similar to those of human VKOR (12, 13). The cell-based assay was used to investigate whether these similarities allow some VKORHs to participate in the vitamin K cycle. Initial testing was of VKORHs from four organisms (FIG. 15A): Arabidopsis thalania (AR-VKORH), which has vitamin K to KH₂ activity and a Trx-like domain at its C-terminus, but is insensitive to warfarin (19), Mycobacterium tuberculosis (MT-VKORH), which has no Trx-like domain but is active in E. coli protein folding and is reported to be warfarin sensitive (9), Roseiflexus sp. (RO-VKORH), which has a N-terminal Trx-like domain, and Synechococcus sp. (SY-VKORH), which can reduce vitamin K to KH₂ and whose crystal structure has been reported (20). These enzymes were transiently expressed in the established cell line (FIXgla-PC/HEK293) and the cells were cultured in the presence of 5 μM KO and 4 μM warfarin. Of the VKORHs tested, only MT-VKORH supported carboxylation of the reporter protein (FIG. 15B). MT-VKORH has 2.5-fold higher activity than human VKOR-Y139F. Since VKOR-Y139F has ˜40% of wild-type activity (18,25); this result suggests that MT-VKORH has activity similar to that of wild-type human VKOR.

The Effect of Cysteine Mutations on MT-VKORHs Ability to Support In Vivo VKD Carboxylation with KO as Substrate.

Both pairs of the conserved cysteines, C57/C65 and C139/C142, in MT-VKORH are essential for complementing DsbB deletion in E. coli (35). To examine the importance of these conserved cysteines in the vitamin K cycle, MT-VKORH with alanine mutations at each cysteine (C57A, C65A, C139A, and C142A) as well as with the double mutant, C57A/C65A in FIXgla-PC/HEK293, were transiently expressed. Mutation of either of the cysteines (C139 or C142) in the CXXC redox center abolishes its ability to support VKD carboxylation (FIG. 16). These mutations also abolish MT-VKORH ability to complement DsbB deletion in E. coli (8). MT-VKORH C57A mutant has <10% VKD carboxylation activity (FIG. 16). On the other hand, C65A and C57A/C65A mutants retain 50% to 70% activity of the wild-type MT-VKORH. This result suggests that loop cysteines C57/C65 are not directly involved in the reduction of KO in mammalian cells. Thus, the reaction mechanisms utilized for DsbB complementation in E. coli (35) and for the conversion of KO to vitamin K in mammalian cells by MT-VKORH appear to be different.

The Effect of Cysteine Mutations on Human VKOR In Vivo Activity.

To examine the role of the cysteines in VKOR in vivo, the cysteines were changed to alanines in the warfarin-resistant VKOR-Y139F molecule and these enzymes were transiently expressed in FIXgla-PC/HEK293. The in vivo results (FIG. 17A) are similar to previous in vitro results except that C16A mutation has no effect on activity in vivo but has ˜40% activity in the in vitro assay. Only mutations of the active site residues, C132 and C135, reduce activity to background levels. C43A has ˜30% activity in the in vitro assay but ˜5% activity in the in vivo assay. C51A has activity similar to that of wild-type VKOR in both assays. To confirm the role of C43 and C51, both cysteines were mutated to alanine, or both cysteines and the sequences between them were deleted. As shown (FIG. 17B), in either case the molecule still retains ˜60% activity. In addition, mutating all five non-active site cysteines simultaneously to alanine results in a molecule with ˜40% activity. These results together suggest that the conserved loop cysteines C43 and C51 are not required for VKOR activity (17).

Cysteine Residues 57 and 65 of MT-VKORH are Located in the ER Lumen.

Membrane topology studies of MT-VKORH in E. coli indicate that C57 and C65 are located in the periplasm, the same side of the bacterial inner membrane as the CXXC redox center (35). According to previous work, the corresponding conserved pair of cysteines 43 and 51 of human VKOR are located in the cytoplasm, i.e., on the opposite side of the ER membrane from the CXXC redox center (32) (FIG. 18A). The function of C57 and C65 of MT-VKORH in reducing KO in mammalian cells appears to be similar to that of C43/C51 of human VKOR, but different than that in E. coli. One reason for this might be that MT-VKORH has different membrane topology in E. coli and mammalian cells.

To clarify this issue, the N-linked glycosylation mapping technique (5) was used to determine the MT-VKORH membrane topology in HEK293 cells. These results show that introducing glycosylation sites causes MT-VKORH to migrate slower than wild-type enzyme in SDS-PAGE (FIG. 18B, lanes 3 and 5). These higher molecular weight molecules are sensitive to the endoglycosidase digestion (FIG. 18B, lanes 4 and 6) indicating the introduced sites are glycosylated. Therefore, the cysteine pair C57/C65 and the C-terminus of MT-VKORH are located in the ER lumen, which is consistent with the periplasmic location in bacteria (35). Glycosylation at the C-terminus does not affect MT-VKORH activity, while glycosylation in the loop between C57 and C65 decreases activity 50% compared with that of the wild-type enzyme (FIG. 18C). Together with the cysteine mutation results of human VKOR (FIG. 17), this result further suggests that whether the conserved cysteine pair is located in the cytoplasm or ER lumen, they are not required for the reduction of the CXXC redox center.

Support of VKD Carboxylation by VKORH with Vitamin K as Substrate in AV12 Cells.

Results to this point indicate that MT-VKORH can reduce KO to vitamin K, but provide no information about its activity for vitamin K to KH₂. In contrast to HEK293 cells, which have a warfarin-resistant vitamin K reductase, it was shown that AV12 cells have almost no antidotal enzyme. This makes AV12 cells a good model for investigating enzymes' ability to utilize vitamin K. To determine whether VKORHs can efficiently reduce vitamin K to KH₂, and thus support carboxylation, the VKORHs were transiently expressed in FIXgla-PC/AV12 cells stably expressing VKOR-Y139F. It was reasoned that if an enzyme that can efficiently reduce vitamin K to KH₂ is introduced, the resulting cell line should produce carboxylated reporter protein when the cells were cultured with KO and warfarin. Of the cell lines transiently expressing VKORHs only those expressing MT-VKORH and RO-VKORH have significant activity (FIG. 19A). VKORHs from Arabidopsis and Synechococcus can reduce vitamin K in vitro (11,20), but they have no significant activity in the in vivo system.

To further confirm MT-VKORH's ability to reduce both KO to vitamin K and vitamin K to KH₂, either MT-VKORH or VKOR-Y139F were transiently expressed in FIXgla-PC/AV12 cells that do not stably express VKOR-Y139F. As previously reported, expression of VKOR-Y139F did not support carboxylation of the reporter protein (31). In contrast, expression of MT-VKORH produced significant carboxylated reporter protein (FIG. 19B). This result further supports the conclusion that MT-VKOKH can reduce both KO and vitamin K. It also supports earlier observations that the main function of human VKOR in the vitamin K cycle is to reduce KO to vitamin K but not vitamin K to KH₂(31).

The Importance of the Dipeptide Sequence Between the Active Site Cysteines for VKOR Activity.

In enzymes with the redox center, CXXC, the dipeptide sequence between the cysteines often plays a crucial role in controlling the enzyme's activity (6,15). VKOR and the VKORHs have different dipeptide sequences in the active site (FIG. 20A). The dipeptide PY in MT-VKORH is a common sequence in the glutaredoxin family's CXXC redox center. The PY sequence causes a pKa <4 for the N-terminal nucleophilic cysteine and high reducing potential (12). To test the effect of the dipeptide sequence on enzyme activity, the dipeptide sequences of human VKOR and MT-VKORH were exchanged. With KO as substrate, changing MT-VKORH's PY to IV decreased its activity to less than 30% compared to that of the wild-type enzyme (FIG. 20B). Changing human VKOR′ s IV to PY caused a modest activity increase.

Reduction of KO and Vitamin K by Other Bacterial VKOR is with Sequences Similar to that of MT-VKORH.

These results suggest that VKORHs without the Trx domain and with the dipeptide sequence PY in the CXXC redox center may be more likely to catalyze both the reduction of KO and vitamin K. To further test this hypothesis, we selected two bacterial VKORHs that meet these criteria; CO-VKORH (From Corynebacterium jeikeium K411) and SA-VKORH (From Salinispora tropica CNB-440). The CXXC active site sequence and sequences on either side of the active site are conserved in these enzymes (FIG. 21A). As shown, with KO as substrate, SA-VKORH and CO-VKORH have 30% and 70% activity relative to MT-VKORH respectively (FIG. 21B). To determine whether these enzymes can use vitamin K to support carboxylation, they were expressed in FIXgla-PC/VKOR-Y139F/AV12 cell lines. Compared with MT-VKORH, these two VKORHs' ability to reduce vitamin K to KH₂ is higher than the KO to vitamin K reduction (FIG. 21C).

Initially three bacterial and one plant (Arabidopsis) VKORH, two of which have been reported to reduce vitamin K (2,14), were investigated, to see if any could support VKD carboxylation in vivo. Of these, only MT-VKORH can employ KO in mammalian cells to catalyze carboxylation of our reporter protein (FIG. 15). But with vitamin K as substrate, both MT-VKORH and RO-VKORH (although to a lesser extent) can support VKD carboxylation (FIG. 19). This result is particularly interesting; first because MT-VKORH is the only non-eukaryotic enzyme shown to reduce KO to vitamin K; second because, as opposed to VKOR, it efficiently uses either KO or vitamin K as substrate; and finally the active sites of both MT-VKORH and RO-VKORH can be reduced in vivo by the physiologic reductant for VKOR. This result also allowed for a comparison of the structure-function characteristics of human VKOR with a bacterial enzyme in a system where they are both active.

When MT-VKORH complements DsbB deletion mutants in E. coli, both the active site cysteines and the loop cysteines are important for this function (35). In contrast, these results indicate that, like the VKOR (FIG. 17), only the active site cysteines are required for MT-VKORH function in mammalian cell VKD carboxylation, (FIG. 16). According to previous results, the human VKOR (32) loop cysteines are in the cytoplasm, but according to Wang et al. the MT-VKORH (35) loop cysteines are located in the periplasm of E. coli. Therefore a possible explanation for the different results in E. coli and this system concerning the loop cysteines is that MT-VKORH has a different membrane topology in HEK293 cells than in E. coli. These results show this is not the case (FIG. 18). These results indicate that there are at least two mechanisms by which the active site of the reductases can be reduced.

In the bacteria periplasm, the loop must interact with DsbA to support disulfide formation during protein folding which is necessary for cell motility. During this process it in turn reduces the active site CXXC to complete a cycle to the active enzyme. On the other hand, the mammalian loop apparently plays only a secondary role in any reducing cycle other than that of vitamin K. If this were not the case, it seems likely that warfarin treatment might affect important cellular functions other than vitamin K production and cause negative physiological effects. In addition, the murine knockout of VKOR would not be viable when fed vitamin K (28). This suggests that in the mammalian system reduction of the active site CXXC must be catalyzed directly and inter-molecularly by an as yet unidentified reducing protein/molecule (FIG. 22).

As mentioned above, in contrast to VKOR, the MT-VKORH can efficiently use either KO or vitamin K as substrate in carboxylation. One reason for this could be the difference of the dipeptide sequence in the CXXC redox center. The dipeptide between the two cysteines plays a crucial role in controlling the enzyme activity by an effect on the pKa of the N-terminal cysteine (6,15). In VKOR, the dipeptide is IV; while in MTVKORH it is PY (FIG. 20A). The PY sequence causes a low pKa (<4) for the N-terminal nucleophilic cysteine and a high redox potential for the active site (12). When the dipeptides were exchanged between MT-VKORH and human VKOR the mutant MTVKORH had significantly lower activity with KO, but the effect on VKOR was modest indicating that other unidentified structural features are important in VKOR.

To study the importance of the sequence adjacent to the active site, two other bacterial VKORH with sequences similar to that of MT-VKORH were tested. Both enzymes supported VKD carboxylation with KO or vitamin K as substrate (FIG. 21). These results indicate that the dipeptide sequence and adjacent residues are important for in vivo reduction of vitamin K. It is interesting to note that the homologues that support both reductions have conserved sequences surrounding the active site that are quite different from that of VKOR (FIG. 19A).

In summary, these studies have shown that VKORH from Mycobacterium tuberculosis can reduce both KO and vitamin K to support VKD carboxylation in mammalian cells. In contrast to its function in oxidative protein folding in E. coli, the conserved loop cysteines are apparently dispensable for supporting VKD carboxylation in mammalian cells. In addition it appears in the mammalian system that membrane topology, as long as the active site is in the ER lumen, does not affect enzyme activity. These results indicate that MT-VKORH can function by two physiologically relevant mechanisms depending on its cellular environment.

REFERENCES FOR EXAMPLE IV

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Example 5 Vitamin K Epoxide Reductases with Modified Membrane Topology and Increased Activity

Methods: To further confirm the topological structure of human VKOR and to better understand its reaction mechanism, fluorescence protease protection assays and selective chemical modification of the endogenous cysteines were used to probe the membrane topology of human VKOR in mammalian, HEK 293 cells.

Results: The present results support the previously reported three-TMD model [see FIG. 29A (three TMD model) and FIG. 29B (four TMD model] suggesting that the N-terminus of VKOR is located in the ER lumen and the conserved cysteine loop is located in the cytoplasm. In addition, the membrane topology of the VKOR paralogue, VKORC1L1, has been examined. In contrast to VKOR, VKORC1L1 has four TMDs, which is similar to the membrane topology of the VKOR domain of Synechococcus. This topological model places the conserved cysteine loop in the ER lumen. Cell-based in vivo activity assays indicate that both VKOR and VKORC1L1 are active in the vitamin K cycle.

Conclusion: VKOR and VKORC1L1 have different membrane topologies. Whether the loop cysteines are located in the ER lumen or the cytoplasm, they are not directly involved in catalysis.

This aspect of the present invention is directed to modifying or mutating human VKOR to increase its ability to produce carboxylated vitamin K dependent proteins (e.g., increased amount of carboxylated vitamin K dependent proteins as compared to a human VKOR protein that does not have the modifications and/or mutations of this invention). Specifically, the charge distribution of several residues on either side of the first transmembrane domain has been changed. Since there are an excess of positive charges on what is believed to be the cytoplasmic side of the membrane, these residues have been altered in the following way; specifically arginines 33, 35, and 37 were changed to glycine and lysine 30 was changed to leucine. On the other side of the first transmembrane domain glycine 6, serine 7, and glycine 9 were changed to arginines. These changes appear to have changed the topology of human VKOR and also increase the ability of the human VKOR to carboxylate a vitamin K dependent reporter protein by approximately fourfold (see pages 67-69).

FIGS. 30A-B demonstrate the positive inside rule. The major discoveries relating to the positive inside rule were initiated by von Heijne. The orientation of the transmembrane helix is primarily determined by the charged residues flanking the hydrophobic core. Positively charged residues are four times more abundant on the cytoplasmic side (inside) of membrane proteins as compared to the trans side. Moving of the positively charged residue from the cytoplasmic side to the ER luminal side can result in inversion of TMD orientation. FIGS. 24, 25 and 26 show alignments of VKORs from human, Mycobacterium and Synechococcus. In human VKOR, there are five positive charges very close to TMD1 (see FIG. 31A) and there are three a little farther out in the human VKOR sequence. These charges indicate an excess of positive charges and indicate that this loop would likely reside in the cytoplasm. The VKOR sequence of Synechococcus has only two positive charges in the same segment and has four positive charges amino terminal to TMD1. Changing these residues is expected to result in a molecule with an altered amino terminus and altered transmembrane domain topology.

FIG. 31B shows the prediction of wild type human VKOR topologies and FIG. 31C shows the predicted topologies after mutations. In FIG. 31A, the residues that were changed are designated by arrows. These changes are described above.

FIG. 32 shows that the mutations that were made convert human VKOR to a molecule about four times more active than wild type VKOR.

Further included in this invention is a human VKOR protein comprising a V45N substitution, which introduces an additional glycosylation site. A human VKOR protein comprising this substitution has increased carboxylation activity as shown in FIG. 33. This human VKOR can be employed in the methods of this invention. This human VKOR can comprise any of the mutations described herein in any combination.

Also included in this invention is a human VKOR protein comprising a substitution of amino acids 44-50 (DVGTAIS) with the amino acid sequence DYKDDDDK (FLAG tag sequence). The increased activity of this VKOR mutant is shown in FIG. 23.

The foregoing is illustrative of the present invention, and is not to be construed as limiting thereof. The invention is defined by the following claims, with equivalents of the claims to be included therein.

All publications, patent applications, patents, patent publications, GenBank® database accession numbers and other references cited herein are incorporated by reference in their entireties for the teachings relevant to the sentence and/or paragraph in which the reference is presented.

TABLE 1 Organism Compared to: % Identity Relative activity: Human Y139F Human Mycobacterium 19.9 Yes, greater tuberculosis Human Acropora 46.1 Yes, greater Human Nematostella 47.1 Yes, greater Human Anopheles 38.8 NA Human Hamster ~80.0 Yes, greater Human Takifugu 45.7 Yes, greater Human Xenopus 50.9 Yes, greater tropicalis Human Mouse 83.0 NA Human Ciona 37.6 Yes, greater Human Amphioxus 38.7 Yes, greater Human Danio rerio 45.7 NA Human Rat 82.8 NA Human Drosophila 36.2 NA Human Platypus 44.6 No Human Trichoplax 42.3 No

TABLE 2 Human 122-WILFFVLYDFCIVCITTY-139 Roseiflexus sp. RS-1 300-FLEPFVIGATCLWCLTSA-317 Synechococcus 120-YLMVAVLRQFCMYCTTAI-137 Arabidopsis 185-ILSTKLSGSSCLYCLVSA-202 M tuberculosis 129-FQSLYRIGALCPYCMVVW-146 DsbB  33-WFQHVMLLKPCVLCIYER- 50 

1. A method of increasing the amount of carboxylated vitamin K dependent protein in a cell, comprising introducing, into a cell that expresses a first nucleic acid encoding a vitamin K dependent protein, a second nucleic acid comprising a heterologous nucleotide sequence encoding vitamin K epoxide reductase (VKOR), wherein the heterologous nucleotide sequence encoding VKOR is selected from the group consisting of: 1) a nucleotide sequence that encodes an amino acid sequence having at least 19% identity but not greater than about 79% identity with the amino acid sequence of human VKOR; 2) a nucleotide sequence that encodes a Mycobacterium tuberculosis VKOR; 3) a nucleotide sequence that encodes an Acropora; 4) a nucleotide sequence that encodes a Nematostella VKOR; 5) a nucleotide sequence that encodes an Amphioxus VKOR; 6) a nucleotide sequence that encodes a Takifugu VKOR; 7) a nucleotide sequence that encodes a Ciona VKOR; 8) a nucleotide sequence that encodes a hamster VKOR; 9) a nucleotide sequence that encodes a Drosophila VKOR; 10) a nucleotide sequence that encodes a human VKOR comprising a C51A mutation; 11) a nucleotide sequence that encodes a human VKOR comprising an IV133-134PY mutation; 12) a nucleotide sequence that encodes a human VKOR comprising a C51A mutation and an IV133-134PY mutation; 13) a nucleotide sequence that encodes a human VKOR comprising a V45N mutation; 14) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 44-50 with amino acids DYKDDDDK; 15) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR with amino acids 129-146 (FQSLYRIGALCPYCMVVW) of Mycobacterium tuberculosis VKOR; 16) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR with amino acids 185-202 (ILSTKLSGSSCLYCLVSA) of Arabidopsis VKOR; 17) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human with amino acids 120-137 (YLMVAVLRQFCMYCTTAI) of Synechococcus VKOR; 18) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human with amino acids 33-50 (WFQHVMLLKPCVCIYER) of a bacterial DsbB enzyme; and/or 19) a nucleotide sequence that encodes a human VKOR comprising a substitution of amino acids 122-139 (WILFFVLYDFCIVCITTY) of human VKOR with amino acids 300-317 (FLEPFVIGATCLWCLTSA) of Roseiflexus VKOR, under conditions whereby said first and second nucleic acids are expressed to produce a vitamin K dependent protein and VKOR, respectively, thereby increasing the amount of carboxylated vitamin K dependent protein in the cell. 2-32. (canceled) 